ArticleGlobal spine journal2024
Effect of High-Riding Vertebral Artery on the Accuracy and Safety of C2 Pedicle Screw Placement in Basilar Invagination and Related Risk Factors.
Article in Global spine journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Prevalence of the high-riding vertebral artery depends on how it is defined: a meta-analysis with implications for C2 screw fixation.Anatomical science international · 2026Review
- [Experimental study of patient-specific three-dimensional-printed drill guide-assisted CZhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Article
- Review
- Endoscopic Transnasal Approach to Atlantoaxial Decompression and C1-2 Fixation in Basilar Invagination of Adults: A Feasibility Study.Neurospine · 2025Article
- A Novel Technique for Basilar Invagination Treatment in a Patient with Klippel-Feil Syndrome: A Clinical Example and Brief Literature Review.Medicina (Kaunas, Lithuania) · 2024Review
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designRetrospective cohort study.
objectiveTo investigate the effect of HRVA on the intrapedicular accuracy of C2PS placement through the freehand method in patients with BI and analyse the possible risk factors for C2PS malpositioning.
methodA total of 91 consecutive patients with BI who received 174 unilateral C2PS placements through the freehand method were retrospectively included. The unilateral pedicles were assigned to the HRVA and non-HRVA groups. The primary outcome was the intrapedicular accuracy of C2PS placement in accordance with the Gertzbein-Robbins scale. Moreover, the risk factors that possibly affected intrapedicular accuracy were assessed.
resultsThe rate of intrapedicular accuracy in C2PS placement in patients with BI was 23.6%. Results showed that the non-HRVA group had remarkably higher rates of optimal and clinically acceptable C2PS placement than the HRVA group. Nevertheless, the HRVA group exhibited similar results for grade B classification as the non-HRVA group. Moreover, in the HRVA and non-HRVA groups, the most common direction of screw deviations was the lateral direction. Furthermore, the multivariate analyses showed that the obliquity of the lateral atlantoaxial joint in the sagittal plane ≥15°, and that in the coronal plane ≥ 20°, isthmus height < 4.3 mm, and distance from the skin to the spinous process ≥ 2.8 cm independently contributed to a high rate of screw malpositioning in BI patients.
conclusionThe presence of HRVA in BI patients contributed to the high rate of malpositioning in C2PS placement via the freehand method. However, the rates of intrapedicular accuracy in patients with BI with and without HRVA were considerably low.
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