ArticleKorean journal of neurotrauma2020
Freehand Placement of the C1 Pedicle Screw Using Direct Visualization of the Pedicle Anatomy and Serial Dilatation.
Article in Korean journal of neurotrauma, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.
- 3D-printed drill guide versus fluoroscopic-guided free-hand technique for pedicle screw insertion in the upper cervical spine: a systematic review and meta-analysis.Musculoskeletal surgery · 2025Pooled it
- Axis screw parallel to the sagittal plane versus traditional pedicle screw in the treatment of atlantoaxial fixation: a finite element study.BMC musculoskeletal disorders · 2024Article
- Current Concepts in the Treatment of Traumatic C2 Vertebral Fracture : A Literature Review.Journal of Korean Neurosurgical Society · 2024Article
- Novelties for increased safety in cranio-vertebral surgery: a review.Acta neurochirurgica · 2023Review
- Treatment of Upper Cervical Spinal Cord Injury (Unstable C1-C2) by Direct Visualization and Nailing Technique and the Advantages of Early MRI.Journal of healthcare engineering · 2021Article
- An institutional study on accuracy of freehand cervical C1 C2 screws placement by knock and drill technique in craniovertebral anomalous bony anatomy: An evaluation of more than 600 screws based on SGPGI screw accuracy criteria.Journal of craniovertebral junction & spineArticle
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe designed a method for inserting C1 pedicle screws using the direct visualization technique of the pedicle and serial dilatation technique to reduce complications and malposition of screw, and assessed the accuracy of this method.
methodsFree-hand C1 pedicle screw insertion using the direct visualization technique of the pedicle and serial dilatation technique was performed on 5 consecutive patients with C1-2 instability at a single institute from March to December 2018. The method involved protecting the vertebral artery (VA) and C1 root using the Penfield No. 1, securing the entry point of the posterior arch screw and the pedicle was visible directly in Trendelenburg position. The hole at the entry point of the C1 posterior arch was serially dilated using a 2.5×3.0 mm drill bit, and the C1 pedicle screw was inserted with the free hand technique. We measured postoperative radiological parameters and recorded intraoperative complications, postoperative neurological deficits and the occurrence of occipital neuralgia. Postoperative computed tomography (CT) was performed to check screw malposition or construction failure.
resultsOf the 10 C1 pedicle screws on postoperative CT, 20% of screws (grade A) were in the ideal position while 80% of screws (grade B) occupied a safe position. Overall, 100% of screws were safe (grade A or B). There were no iatrogenic neurological deficits, VA injury.
conclusionFreehand placement of the C1 pedicle screw through the direct visualization technique of the pedicle and serial dilatation technique is safe and effective without intraoperative fluoroscopy guidance.
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