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The trabecular anatomy of the axis
1Center for Spinal Disorders, Baylor College of Medicine, Houston, Texas.
Spine
|October 15, 1993
Summary
Internal anatomy of the second cervical vertebra (C2) reveals a hypodense area beneath the dens, impacting internal fixation. Optimal fixation sites are identified in lateral masses and beneath facets, avoiding the hypodense region.
Area of Science:
- Orthopedic Surgery
- Anatomy
- Biomechanics
Background:
- The second cervical vertebra (C2), or axis, is crucial for head mobility and stability.
- Understanding C2's internal bone structure is vital for successful surgical fixation.
Purpose of the Study:
- To investigate the internal trabecular bone distribution of the C2 vertebra.
- To identify optimal anatomical locations for internal fixation device insertion.
- To assess the implications of bone density variations on fixation device purchase.
Main Methods:
- Microscopic examination of C2 specimens to analyze internal bone density and distribution.
- Qualitative assessment of trabecular bone patterns throughout the C2 vertebra.
Main Results:
- All C2 specimens exhibited a hypodense (low-density) bone area immediately beneath the dens.
- Trabecular bone density was nonuniform throughout the C2 vertebra.
- Lateral masses and areas beneath facets showed good cancellous bone quality.
Conclusions:
- The hypodense area in the upper C2 may compromise fixation device purchase and lead to cut-through failure.
- Lateral masses and sub-facet regions are recommended as suitable sites for internal fixation device insertion.
- Nonuniform bone distribution in C2 necessitates careful consideration during surgical planning for internal fixation.