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Journal of Korean Neurosurgical Society 2008;43(2): 119-122.
doi: https://doi.org/10.3340/jkns.2008.43.2.119
Modified Trajectory of C2 Laminar Screw - Double Bicortical Purchase of the Inferiorly Crossing Screw.
Woo Tack Rhee, Seung Hoon You, Yeon Gyu Jang, Sang Youl Lee
Department of Neurosurgery, Gangneung Asan Hospital, College of Medicine, Ulsan University, Gangneung, Korea. seasons@gnah.co.kr
ABSTRACT
The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.
Key Words: Laminar screw; Occipitocervical fixation
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