Evaluation of the Distance of the V3 Segments of the Vertebral Artery to the C1 Lateral Mass and C2 Pedicle on the Dominant and Nondominant Sides: A Cadaver Study
Year 2024,
Volume: 14 Issue: 4, 1003 - 1007
Yahya Güvenç
,
Ural Verimli
,
Erhan Bıyıklı
,
Bahadır Topal
,
İbrahim Ziyal
Abstract
Objective: Aim of this study is investigation of the risk of vertebral artery injury on the dominant and non-dominant vertebral artery sides at the craniocervical junction on cadavers .
Methods: A total of five cadavers and 10 vertebral arteries injected with red latex were studied. Dissection was performed on all of the cadavers. The study also involved CT scans obtained from all of the cadaver specimens. Distance of C1 lateral mass medial wall to the V3 segment of the vertebral artery, distance of C1 lateral mass lateral wall to the V3 segment of the vertebral artery, distance of C2 pedicle medial wall to the V3 segment of the vertebral artery, and distance of C2 pedicle lateral wall to the V3 segment of the vertebral artery were measured and statistically analyzed.
Results: There was no statistically significant difference between anatomical measurements on cadavers and on CT scan measurements. The data in the study demonstrated that the non-dominant (hypoplastic) vertebral artery follows a much closer course to the pedicle and the lateral mass, compared to the dominant artery.
Conclusion: In conclusion, it has been shown that the vertebral artery may be easily injured during surgical procedures due to the anatomical proximity of the pedicle and lateral mass and the screws’ entry points being much closer on the non-dominant side.
Ethical Statement
This study was approved by the Marmara University of Ethical Committee (09.2021.1130)
Supporting Institution
The authors received no financial support for the research.
Thanks
We would like to thank all participants involved in the study
References
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Year 2024,
Volume: 14 Issue: 4, 1003 - 1007
Yahya Güvenç
,
Ural Verimli
,
Erhan Bıyıklı
,
Bahadır Topal
,
İbrahim Ziyal
References
- Farey ID, Nadkarni S, Smith N. Modified Gallie technique versus transarticular screw fixation in C1-C2 fusion. Clin Orthop Relat Res. 1999;(359):126-135. DOI: 10.1097/00003086-199902000-00013
- Wright NM, Lauryssen C. Vertebral artery injury in C1-2 transarticular screw fixation: results of a survey of the AANS/CNS section on disorders of the spine and peripheral nerves. American Association of Neurological Surgeons/Congress of Neurological Surgeons. J Neurosurg. 1998; 88(4):634-640. DOI: 10.3171/jns.1998.88.4.0634
- Barrie U, Detchou D, Reddy R, Tao J, Elguindy M, Reimer C, Hall K, Brown DA, Aoun SA, Bagley CA. Vertebral artery injury with anterior cervical spine operations: A systematic review of risk factors, clinical outcomes, and management strategies. World Neurosurg. 2023; 173:226-236 e12. DOI: 10.1016/j.wneu.2023.02.078
- Khan S, Cloud GC, Kerry S, Markus HS. Imaging of vertebral artery stenosis: A systematic review. J Neurol Neurosurg Psychiatry 2007; 78(11):1218-1225. DOI: 10.1136/jnnp.2006.111716
- Lunardini DJ, Eskander MS, Even JL, Dunlap JT, Chen AF, Lee JY, Ward TW, Kang JD, Donaldson WF. Vertebral artery injuries in cervical spine surgery. Spine J. 2014; 14(8): 1520-1525.DOI: 10.1016/j.spinee.2013.09.016
- Yamaguchi S, Eguchi K, Kiura Y, Takeda M, Kurisu K.Posterolateral protrusion of the vertebral artery over the posterior arch of the atlas: quantitative anatomical study using three-dimensional computed tomography angiography. J Neurosurg Spine 2008; 9(2):167-174. DOI: 10.3171/SPI/2008/9/8/167
- Bible JE, Rihn JA, Lim MR, Brodke DS, Lee JY. Avoiding and managing intraoperative complications during cervical spine surgery. Instr Course Lect. 2016. 65: 281-290. DOI: 10.5435/JAAOS-D-14-00446