Evidence map›Paper›PMID 36384627›Full record

ArticleJournal of orthopaedic surgery and research2022

Application of C2 subfacetal screws for the management of atlantoaxial dislocation in patients with Klippel-Feil syndrome characterized by a narrow C2 pedicle and high-riding vertebral artery.

Zhe Hou, Qiang Jian, Wayne Fan, Xingang Zhao, Yinqian Wang, Tao Fan

Open access · goldAbstract read
In one paragraph

Article in Journal of orthopaedic surgery and research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. C2 direct pedicle screw insertion technique in craniovertebral junction anomaly: safety and efficacy in high-riding vertebral artery cases.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Zhe Hou *Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China.
Qiang Jian *Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China.
Wayne FanFaculty of Science, The University of British Columbia, Vancouver, BC, Canada.
Xingang ZhaoSpine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China.
Yinqian WangSpine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China.
Tao FanSpine Center, Sanbo Brain Hospital, Capital Medical University, Beijing, People's Republic of China. fant@ccmu.edu.cn.
Beijing Sanbo Brain Hospital · CNCapital Medical University · CNUniversity of British Columbia · CA

Funding

Beijing Municipal Science and Technology Commission Z191100006619040
6 · The paper itself

Abstract

objectiveThis study aims to investigate the clinical application and feasibility of C2 subfacetal screws in patients with Klippel-Feil syndrome (KFS), narrow C2 pedicles, and high-riding vertebral arteries (HRVAs).

methodsThe clinical data of seven patients with KFS, atlantoaxial dislocation, narrow C2 pedicles, and HRVAs treated with C2 subfacetal screws were analyzed in this retrospective study. The internal height, isthmus height, and pedicle width of C2 vertebra were measured using preoperative computed tomography (CT). Subfacetal screws were inserted for 7 patients (12 sides). The position and length of the screws were observed using postoperative CT. Intraoperative dura mater and vertebral artery (VA) injuries were recorded. Bone fusion was observed using follow-up CT.

resultsThe internal height was 10.5 ± 3.2 mm, the isthmus height was 3.7 ± 1.8 mm, the pedicle width was 3.0 ± 1.4 mm, and the screw length was 19.7 ± 1.5 mm. All patients had HRVAs and narrow pedicles. No injury to the dura mater and vertebral artery (VA) occurred in this group of patients. Bone fusion was achieved in all patients during follow-up.

conclusionsIn patients with KFS, HRVA, and a narrow C2 pedicle, there is sufficient space below the C2 articular surface for screw insertion. When the pedicle is narrow and the C2 pedicle screw is not suitable for placement due to possible injury to the VA, subfacetal screws are a feasible alternative.

Indexed as

Joint DislocationsKlippel-Feil SyndromePedicle ScrewsSpinal FusionHumansRetrospective StudiesVertebral ArteryAtlantoaxial dislocationC2 subfacetal screwCongenital C2-3 fusionKlippel-Feil syndrome

Identifiers

PMID36384627
PMCPMC9670565
OpenAlexW4309322015

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.