Preoperative oblique axial computed tomographic imaging for C1-C2 transarticular screw fixation: technical note

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Radiology

Background:

• Atlantoaxial instability requires surgical intervention, with C1-C2 transarticular screw fixation being a common and effective method.
• This technique demands high precision due to the narrow safety margin for screw insertion.
• Thorough preoperative assessment is crucial for surgical success and patient safety.

Purpose of the Study:

• To describe a unique and accessible computed tomographic (CT) imaging method for preoperative planning of C1-C2 transarticular screw fixation.
• To enhance the safety and accuracy of this surgical procedure by improving radiological assessment.

Main Methods:

• Utilizing thin-section oblique axial CT images of the C1-C2 region.
• Employing this imaging technique as an adjunct to standard preoperative planning.

Main Results:

• The described CT imaging method provides detailed anatomical information of the C1-C2 region.
• It allows for precise evaluation of bony and vascular structures, aiding in defining screw trajectory tolerances.
• This technique is easily obtainable and can be integrated into routine preoperative workflows.

Conclusions:

• The presented thin-section oblique axial CT imaging method is a valuable tool for preoperative planning of C1-C2 transarticular screw fixation.
• It contributes to improved surgical safety and potentially higher fusion rates by optimizing screw placement.
• This technique enhances the radiological assessment for surgeons performing atlantoaxial stabilization.