Evaluation of type differences of arteria vertebralis with C2 vertebral artery groove variation origin

Abstract

Vertebral artery Groove (VAG) variations at the C2 vertebral level are one of the most important factors determining the risks of C2 pedicle screw surgery. However, there are no accepted guidelines for radiographic parameters that can predict C2 screw placement and probabilty of fracture risk. In our study, we evaluated the type differences in the C2 pedicle caused by the C2 VAG variation of the arteria vertebralis, which is specific to our population, with three-dimensional computed tomography angiography (3D-CTA). Therefore, we aimed to easily estimate the risks of C2 pedicle screw placement by type in patients scheduled for surgery. Measurements were made on a total of 200 patients in 100 female and 100 male patients who underwent cervical 3D-CTA. C2 level VAG variations were categorized into four groups as Type I, Type II, Type III and Type IV. Female, male, right pedicle and left pedicle type comparisons were statistically analysed. It was predicted that screw placement was possible with low risk in Type I, with high risk in Type III and Type IV, and impossible in Type II. Type I pedicle was the most common variation with a rate of 66.5% in men and 48 iin women. There was no significant difference between men and women in the distribution of Type I C2 pedicles in our population (p=0.067, p=0.138). There were statistically significant differences between men and women in the distribution of Type II, Type III and Type IV variations (p=0.008, p=0.037, p=0.0069). Type II pedicle variation was 5% in men and 15% in women. We think that the evaluation of the type differences of the C2 VAG variation origin of the arteria vertebralis in our population will be a guide for surgical interventions in this region.

Keywords

• Axis
• pedicle screwing
• vertebral artery injury
• vertebral artery groove
• narrow pedicle
• 3D-CTA

Supporting Institution

There is no supporting institution

References

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