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The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion

STUDY DESIGN: Prospective human anatomical study. OBJECTIVE: Occipitocervical fusion with occipital plate or condyle screws has shown higher failure rates in those with skeletal dysplasia. The modified occipital condyle screw connects the occipital condyle to the pars basilaris of the occipital bone...

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Autores principales: Dietz, Nicholas, Gruter, Basil Erwin, Haegler, Joshua, Cho, Samuel K., Tubbs, R. Shane, Spiessberger, Alexander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336899/
https://www.ncbi.nlm.nih.gov/pubmed/37448506
http://dx.doi.org/10.4103/jcvjs.jcvjs_27_23
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author Dietz, Nicholas
Gruter, Basil Erwin
Haegler, Joshua
Cho, Samuel K.
Tubbs, R. Shane
Spiessberger, Alexander
author_facet Dietz, Nicholas
Gruter, Basil Erwin
Haegler, Joshua
Cho, Samuel K.
Tubbs, R. Shane
Spiessberger, Alexander
author_sort Dietz, Nicholas
collection PubMed
description STUDY DESIGN: Prospective human anatomical study. OBJECTIVE: Occipitocervical fusion with occipital plate or condyle screws has shown higher failure rates in those with skeletal dysplasia. The modified occipital condyle screw connects the occipital condyle to the pars basilaris of the occipital bone that may achieve fortified bony purchase and serve as a more rigid fixation point. We evaluate anatomical feasibility of a novel cranial fixation technique designed to decrease risk of pseudarthrosis. MATERIALS AND METHODS: Occipital condyles were analyzed morphologically using multiplanar three-dimensional reconstructed, ultra-thin section computed tomography. The following parameters were obtained: occipital condyle length, maximal cross section, location of hypoglossal canal, axial and sagittal orientation of the long axis, occipital condyle pedicle (OCP) diameter, maximal length of OCP screw, and entry point. RESULTS: Forty patients with total of 80 occipital condyles were analyzed and the following measurements were obtained: occipital condyle length 24.1 mm (20.5–27.7, standard deviation [SD]: 2.2); condyle maximum axial cross-section 12.6 mm (9–15.8, SD: 1.9); length of OCP screw 38.9 mm (29.3–44, SD: 5.7); diameter of OCP 3.4 mm (3.2–3.6, SD: 0.2); clearance below hypoglossal canal 4.5 mm (3.4–7, SD: 1.1); and distance of screw entry point from condylar foramen 2 mm (range 0-4, SD 1.6). CONCLUSION: The modified occipital condyle screw connects the condyle with the clivus through the pars basilaris and represents a safe and technically feasible approach to achieve craniocervical fusion in skeletally mature individuals. This cephalad anchor point serves as an alternate fixation point of the occipitocervical junction with increased strength of construct and decreased risk of hardware failure or pseudarthrosis given cortical bone purchase and longer screw instrumentation.
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spelling pubmed-103368992023-07-13 The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion Dietz, Nicholas Gruter, Basil Erwin Haegler, Joshua Cho, Samuel K. Tubbs, R. Shane Spiessberger, Alexander J Craniovertebr Junction Spine Original Article STUDY DESIGN: Prospective human anatomical study. OBJECTIVE: Occipitocervical fusion with occipital plate or condyle screws has shown higher failure rates in those with skeletal dysplasia. The modified occipital condyle screw connects the occipital condyle to the pars basilaris of the occipital bone that may achieve fortified bony purchase and serve as a more rigid fixation point. We evaluate anatomical feasibility of a novel cranial fixation technique designed to decrease risk of pseudarthrosis. MATERIALS AND METHODS: Occipital condyles were analyzed morphologically using multiplanar three-dimensional reconstructed, ultra-thin section computed tomography. The following parameters were obtained: occipital condyle length, maximal cross section, location of hypoglossal canal, axial and sagittal orientation of the long axis, occipital condyle pedicle (OCP) diameter, maximal length of OCP screw, and entry point. RESULTS: Forty patients with total of 80 occipital condyles were analyzed and the following measurements were obtained: occipital condyle length 24.1 mm (20.5–27.7, standard deviation [SD]: 2.2); condyle maximum axial cross-section 12.6 mm (9–15.8, SD: 1.9); length of OCP screw 38.9 mm (29.3–44, SD: 5.7); diameter of OCP 3.4 mm (3.2–3.6, SD: 0.2); clearance below hypoglossal canal 4.5 mm (3.4–7, SD: 1.1); and distance of screw entry point from condylar foramen 2 mm (range 0-4, SD 1.6). CONCLUSION: The modified occipital condyle screw connects the condyle with the clivus through the pars basilaris and represents a safe and technically feasible approach to achieve craniocervical fusion in skeletally mature individuals. This cephalad anchor point serves as an alternate fixation point of the occipitocervical junction with increased strength of construct and decreased risk of hardware failure or pseudarthrosis given cortical bone purchase and longer screw instrumentation. Wolters Kluwer - Medknow 2023 2023-06-13 /pmc/articles/PMC10336899/ /pubmed/37448506 http://dx.doi.org/10.4103/jcvjs.jcvjs_27_23 Text en Copyright: © 2023 Journal of Craniovertebral Junction and Spine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Dietz, Nicholas
Gruter, Basil Erwin
Haegler, Joshua
Cho, Samuel K.
Tubbs, R. Shane
Spiessberger, Alexander
The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title_full The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title_fullStr The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title_full_unstemmed The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title_short The modified occipital condyle screw: A quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
title_sort modified occipital condyle screw: a quantitative anatomic study investigating the feasibility of a novel instrumented fixation technique for craniocervical fusion
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336899/
https://www.ncbi.nlm.nih.gov/pubmed/37448506
http://dx.doi.org/10.4103/jcvjs.jcvjs_27_23
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