Fig 1 - uploaded by Anukoon Kaewborisutsakul
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(A) Axial view of C2 pedicle screw placement, grade 0 on both sides. (B) Axial view of C1 lateral mass screw placement, grade 0 on both sides. (C-D) Axial, and coronal view of C2 pedicle screw placement, grade I on the left side. (E-G) Axial, coronal, and sagittal view of C2 pedicle screw placement, grade 0 on the right side and grade II on the left side.
Source publication
Objective: Posterior screw fixation via a C1 lateral mass screw combined with a C2 pedicle screw is a well-known technique for atlantoaxial instability. However, screw malposition can occur because of the complex anatomical structure of this region. This study aimed to evaluate the accuracy and risk factors of cortical breach following the C1 later...
Context in source publication
Context 1
... screw accuracy was evaluated by two independent reviewers using postoperative CT scans. Screw placement was classified into 4 grades [10]: grade 0: no perforation, with the screw accurately inserted into the pedicle; grade 1: minor perforation, <2 mm; grade 2: major perforation, >2 mm and < 4 mm; grade 3: Complete perforation, >4 mm ( Fig. ...
Citations
... Real-time image-guided navigation systems have greatly reduced the risks of VA, spinal cord, and nerve root injuries during posterior C1-C2 fixation surgeries [7]. The literature reveals varying incidence rates of VA injury during cervical spine surgeries, attributed to different surgical techniques. ...
Despite advancement in surgical innovation, C1-C2 fixation remains challenging due to risks of screw malposition and vertebral artery (VA) injuries. Traditional image-based navigation, while useful, often demands that surgeons frequently shift their attention to external monitors, potentially causing distractions. In this article, we introduce a microscope-based augmented reality (AR) navigation system that projects both anatomical information and real-time navigation images directly onto the surgical field. In the present case report, we discuss a 37-year-old female who suffered from os odontoideum with C1-C2 subluxation. Employing AR-assisted navigation, the patient underwent the successful posterior instrumentation of C1-C2. The integrated AR system offers direct visualization, potentially minimizing surgical distractions. In our opinion, as AR technology advances, its adoption in surgical practices and education is anticipated to expand.
