ReviewCureus2026
High-Riding Vertebral Artery in Cervical Spine Surgery: A Review of Preoperative Identification and Surgical Implications.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Occipital plate-assisted posterior reduction for tumor-related severe atlantoaxial dislocation: a single-case surgical technique.Journal of spine surgery (Hong Kong) · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
High-riding vertebral artery (HRVA) is an important anatomical variant of the vertebral artery that poses significant challenges during cervical spine surgery, particularly at the C1-C2 level, where it reduces the safe corridor for pedicle screw placement and increases the risk of arterial injury. This narrative review summarizes current evidence regarding the definition, prevalence, imaging identification, and surgical implications of HRVA, along with risk mitigation strategies. Radiographically, HRVA is most commonly defined by reduced C2 isthmus height (C2IsH) (≤5 mm) and/or internal height (C2InH) (≤2 mm) on computed tomography (CT) scans. Reported prevalence varies widely across populations, typically ranging from 10% to 25%, with higher rates observed in selected patient cohorts. The presence of HRVA necessitates careful perioperative planning, including comprehensive imaging and modification of surgical techniques, such as the use of alternative fixation strategies, including pars screws, laminar screws, navigation-assisted instrumentation, and artery mobilization. Advances in CT angiography (CTA), alternative fixation strategies, surgical navigation, and emerging predictive models may further improve risk stratification and operative safety. Recognition of HRVA and tailored surgical planning are essential to minimize the risk of vertebral artery injury (VAI) and to optimize patient outcomes in cervical spine surgery and instrumentation.
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Registered trials
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.