ArticleSurgical and radiologic anatomy : SRA2021
The internal carotid artery and the atlas: anatomical relationship and implications for C1 lateral mass fixation.
Article in Surgical and radiologic anatomy : SRA, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed, 4 citations in OpenAlex.
- Life-size 3D modeling for C1-C2 fixation planning: A preoperative tool for atlantoaxial stabilization techniques.Brain & spine · 2026Article
- Abdominal Arterial Translation in Lower Lumbar Spine Level Due to Positional Change: A Clinical Survey Using Intraoperative Computed Tomography.Journal of clinical medicine · 2024Article
- Cervical Spine Navigation and Enabled Robotics: A New Frontier in Minimally Invasive Surgery.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2021Review
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Authors and funding
4 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe internal carotid artery (ICA) is potentially at risk during posterior fixation of C1. In this study, we performed a CT-based anatomical analysis of the relationship between the internal carotid artery and the lateral mass of the atlas.
methodsWe analysed 30 CT angiography of the cervical spine, and we measured on both sides the distance of the carotid artery from the midline, distance of the ICA from the anterior cortex of C1 and from the ideal C1 screw entry point. We measured the angle between the sagittal plane passing through the entry point and the tangent line of the vessel. Separated statistical analysis between left and right sides, between male and female patients, and differentiation by age were also performed.
resultsSixty ICAs were studied. The mean distance of the ICA from the midline was 23.3 ± 4.3 mm, with a minimum of 15 mm. The distance between the ICA and the anterior cortical layer of C1 was 4.8 ± 2.7 mm, with a minimum of 1.1 mm. The distance between the screw entry point and the arterial wall was 22.6 ± 2.8 mm, with a minimum of 17.5 mm. The mean angle was 10.4°, with a minimum of 11°.
conclusionsAlthough rare, intraoperative lesion of the ICA is reported and the spine surgeon must be aware of this risk. Careful preoperative planning is mandatory and the position of the ICA in relation to C1 must be assessed. The anatomical parameters presented in this paper can be useful to reduce the risk of ICA injury.
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