ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
The radiological evaluation of posterior occipital condyle-C1 lateral mass screw fixation for patients with basilar invagination and atlas assimilation.
Article in 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. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
STUDY
designRetrospective radiological study. PURPOSE: To evaluate the anatomical feasibility of posterior occipital condyle-C1 lateral mass (OCLM) screw fixation in patients with basilar invagination (BI) and atlas assimilation (AA).
methodsThin-section cervical CTA of 73 patients (25 M / 48 F; 46.4 ± 12.4 year) was reconstructed. (1) Anatomical variables—hypoglossal canal height (HC), canal-to-insertion point height (HCH), upper (UL) and lower (LL) lines, internal (IH) and external (EH) heights—were measured. (2) Screw trajectories: cephalad angles (HCT/IT·CA), medial convergence angles (MMA, IMA, OMA) and lengths (MMAL, OMAL). 3-D CT classified V3 vertebral artery courses. Sex and side differences were tested (t-test/χ², P < 0.05).
resultsMean HC 3.7 ± 1.1 mm, UL 12.2 ± 3.2 mm, LL 17.5 ± 3.2 mm, IH 11.5 ± 3.1 mm, EH 17.1 ± 3.6 mm; angles HCT·CA 61.4°, IT·CA 29.7°, MMA 27.7°, IMA − 9.6°, OMA 9.0°; MMAL 23.4 mm, OMAL 18.8 mm. Three VA risk types were identified: Type I 59.3% (low), Type II 31.9%, Type III 8.8% (high). In 10 of 140 sides, the occipital bone was positioned too low to permit screw insertion without resection.; posterior OCLM screws were feasible in 92.9%.
conclusionsPosterior OCLM screws can be safely inserted at the posterior midpoint; when occipital bone obscures this site, relocation to the posterior margin of the OCLM inferior endplate preserves feasibility > 90%.
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