This document discusses the cervicothoracic junction (CTJ) region of the spine, which spans from C7 to T3. It covers various pathologies that can affect the CTJ including trauma, tumors, metastases, and iatrogenic instability. Surgical treatment approaches for the CTJ are also summarized, including both posterior approaches like laminectomy and instrumented fusion as well as combined anterior-posterior procedures.
Brachial Plexus Injury in Abdominal and Breast Surgery_ Crimson PublishersCrimsonpublisherssmoaj
Brachial Plexus Injury in Abdominal and Breast Surgery by Eyüp Murat Yılmaz* and Ethem Bilgiç in Crimson Publishers: Annals of Medicine and Surgery
Brachial plexus injury is a picture of the upper extremity that leads to numbness, pain, and limitation of movement, usually seen in newborns and trauma cases. Iatrogenically, it is observed after thorax, orthopedics, breast, and abdominal surgeries nevertheless it is quite rare. Risk factors exist and treatment and management seem to be a challenging clinical condition.
https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000526.php
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more Articles on Annals of Medicine and Surgery
Please click on link: https://crimsonpublishers.com/smoaj/index.php
In thoracolumbar spine trauma, the biomechanical goals in minimally invasive fracture treatment include decompression of the spinal canal, reduction of spinal deformities, and maintenance of stable fixation of the spine to permit early mobilization.
This was a teaching lecture given by Prof. Mohamed Mohi Eldin, professor of neurosurgery, in the Multi- Institutional Neurosurgical Meeting, Kasr El Aini Hospital, Cairo University, April 2nd, 2009.
Conservative management in 3 and 4 part proximal humerus fractureBipulBorthakur
Proximal humerus fracture is common in both young as well as elderly people with most of the elderly patients unable to undergo operative management. This study is to see the aspect of conservative management in proximal humerus fracture.
Brachial Plexus Injury in Abdominal and Breast Surgery_ Crimson PublishersCrimsonpublisherssmoaj
Brachial Plexus Injury in Abdominal and Breast Surgery by Eyüp Murat Yılmaz* and Ethem Bilgiç in Crimson Publishers: Annals of Medicine and Surgery
Brachial plexus injury is a picture of the upper extremity that leads to numbness, pain, and limitation of movement, usually seen in newborns and trauma cases. Iatrogenically, it is observed after thorax, orthopedics, breast, and abdominal surgeries nevertheless it is quite rare. Risk factors exist and treatment and management seem to be a challenging clinical condition.
https://crimsonpublishers.com/smoaj/fulltext/SMOAJ.000526.php
For more Open access journals in Crimson Publishers
Please click on: https://crimsonpublishers.com/
For more Articles on Annals of Medicine and Surgery
Please click on link: https://crimsonpublishers.com/smoaj/index.php
In thoracolumbar spine trauma, the biomechanical goals in minimally invasive fracture treatment include decompression of the spinal canal, reduction of spinal deformities, and maintenance of stable fixation of the spine to permit early mobilization.
This was a teaching lecture given by Prof. Mohamed Mohi Eldin, professor of neurosurgery, in the Multi- Institutional Neurosurgical Meeting, Kasr El Aini Hospital, Cairo University, April 2nd, 2009.
Conservative management in 3 and 4 part proximal humerus fractureBipulBorthakur
Proximal humerus fracture is common in both young as well as elderly people with most of the elderly patients unable to undergo operative management. This study is to see the aspect of conservative management in proximal humerus fracture.
Background: Posterior lumbar interbody fusion is acknowledged as the technique designed to take an advantage of making
circumferential fusion by a single approach while avoiding the injury to anterior vascular structures. However, due to the increasing usage of the interbody techniques, there are emerging case reports and series of the vascular injury followed by the interbody fusion in addition to ALIF.
Background: Posterior lumbar interbody fusion is acknowledged as the technique designed to take an advantage of making
circumferential fusion by a single approach while avoiding the injury to anterior vascular structures. However, due to the increasing usage of the interbody techniques, there are emerging case reports and series of the vascular injury followed by the interbody fusion in addition to ALIF.
CHEST INJURY- BLUNT/ Trauma Surgery
Dear viewers,
Greetings from “Surgical Educator”
Today I have uploaded a video on CHEST INJURY- BLUNT- an important topic in trauma. Even the blunt chest trauma can turn into penetrating one because of jagged edges of the broken ribs. I haven’t talked elaborately but have included the essential minimum an undergraduate medical student should know. I have talked about pathophysiology, clinical approach, symptoms, signs, investigations, different individual types of Chest injuries and management of all the varieties of Chest injuries. My aim is, after watching this video all of you should be able to arrive at a correct working diagnosis of the type of chest injury and should also be able to institute immediate lifesaving treatment to the patients if there is a need. You can watch the video in the following links:
surgicaleducator.blogspot.com
youtube.com/c/surgicaleducator
Thank you for watching the video.
The Rotator Interval A Link Between Anatomy and Ultrasound.pdfThoiPham12
discussing the anatomical details of the rotator interval of the
shoulder, correlate the anatomy with normal ultrasound images
and present selected pathologies
A comparative study on the clinical and functional outcome of limb salvage su...NAAR Journal
The aim of this study was to analyze the survival, recurrence, complications as well as the quality of life (QOL) in tibial osteosarcoma (OSA) patients managed by limb salvage surgery (LSS), either by a prosthesis, resection or graft or by amputation. 106 tibial osteosarcoma patients were enrolled where 39 had custom-designed endoprosthetic arthroplasty (LSS1), 36 underwent resection and bone graft (LSS2) while only 31 underwent amputation. A Comparison was done based on post-operative survival rates, postoperative recurrence, and complications. The impact of the patient’s QOL was also evaluated.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Surgical Site Infections, pathophysiology, and prevention.pptx
The midline and lateral parascapular extrapleural exposures
1. TThhee mmiiddlliinnee aanndd llaatteerraall ppaarraassccaappuullaarr
eexxttrraapplleeuurraall eexxppoossuurreess..
AAddvvaannttaaggeess,, ddiissaaddvvaannttaaggeess aanndd ssttaabbiilliizzaattiioonn tteecchhnniiqquueess
GEORGE SAPKAS
ASC. PROFESSOR
1st Orthopaedic Department
Medical School-Athens University
Attikon Hospital
Metropolitan Hospital
Athens Greece
2. The cervicothoracic
junction (CTJ) is a
unique region in the spine.
Biomechanically, it has
unique mechanical
properties because of the
transition between the
cervical and the thoracic
spine.
3. The CTJ represents a
region that transitions
from the fairly mobile
cervical spine to the
fairly rigid thoracic
spine
An HS, et al. Spine 1994
4. The thoracic spine
is immobile because of
the rib cage, which limits
the mobility significantly.
In addition, it represents a
transition from the
lordotic cervical spine to
the kyphotic thoracic
spine
An HS, et al. Spine 1994
5. Radiographically,
it is a region that is
difficult to image,
particularly in
traumatic injury.
6. Surgically,
it may be difficult to
access this region
because of the
manubrium, sternum,
and neurovascular
structures in the
region.
7. Anatomically,
the CTJ posterior
has characteristics
that pose special
considerations to
spinal
instrumentation.
8. Strictly speaking, the
CTJ should involve the
C7 vertebra, the T1
vertebra, the disc
between these two
vertebrae, and their
associated ligaments.
C7
T1
9. Other investigators
include the T2 and
sometimes the T3-T4
vertebrae when
discussing the CTJ.
C6
T1
C7
T2
T3
Le Hoang et al, Neursurg 2003
Frank L Acosta et al, Spine, 2007
T4
10. Lesions involving the
T2 and T3 vertebrae
often face similar
difficulties for getting
access to them
through an anterior
approach.
C6
C7
T1
T2
T3
11. In addition, many of
the spinal fusion
constructs of the CTJ
often involve the T2
or T3 vertebra, and for
these reasons, the CTJ
can be defined as the
region involving the
C7 to T3 vertebrae.
12. As a result, this puts
significant stress
on the CTJ in the
static and dynamic
states.
Disruptions to the
structures in this
region can thus lead
to instability.
An HS, et al. Spine
13. Common causes
of
instability include:
An HS, et al. Spine 1994
Yasuoka S, et al. J Neurosurg 1982
Steinmetz MP, et al. J Neurosurg Spine 2006.
Schlenk RP, et al Neurosurg Focus 2003.
18. Trauma to the CTJ
ranges from 2% to 9%
of all cervical spine
trauma
Nichols CG, et al Ann Emerg Med 1987.
Evans DK. J Bone Joint Surg Br 1983.
Amin A, et al J Spinal Disord Tech 2005
C7
T1
19. Especially important is that a
significant number of CTJ injuries
are missed during the initial
evaluation
Injuries to the CTJ usually involve
fractures or dislocations
Ligamentous injuries, burst
fractures, and facet fractures are
common causes of fractures and
dislocations.
An HS, et al. Spine 1994
Amin A, et al J Spinal Disord Tech 2005.
Chapman JR, et al J Neurosurg 1996
Sapkas G, et al Eur Spine J 1999
20. Posterior fixation is
performed in almost all
cases, and this may be
supplemented with
anterior fixation
An HS, et al. Spine 1994
Chapman JR, et al J Neurosurg 1996
Sapkas G, et al Eur Spine J 1999
22. Tumors of the CTJ are
a common cause of
instability in the region.
Metastatic lesions are
much more common
than primary tumors in
this region.
M. Riz.
F 41
15-6-1997
Chondrosarcoma
23. Primary tumors of the CTJ
may include:
angiosarcoma
chordoma
Lymphoma
plasmacytoma
Schwannoma
Osteosarcoma
giant cell tumor
An HS, et al. Spine 1994
Le Hoang, et al Neurosurg Focus 2003
CCaavveerrnnoouuss hheemmaaggiioossaarrccoommaa
24. Metastatic lesions include:
distant metastases (eg,
prostate, breast)
and
local extension of tumor
Le Hoang, et al Neurosurg Focus 2003
Mazel C, et al. Spine 2004
Pneumon’s metastasis
25. A pancoast
tumor often extends into
the junction between the
rib and the vertebral body,
but the vertebra is not
always involved.
PPaannccooaasstt
26. Other local tumors
include:
thyroid
and
esophageal tumors
that erode into the
vertebrae of the CTJ
Mazel C, et al. Spine 2004
Ulmar B, et al Acta Orthop Belg 2005
30. The two strategies are :
palliative
cord decompression and
spine stabilization
versus
curative with en bloc
radical resection of the
tumor and stabilization
Mazel C, et al. Spine 2004
31. A decompression
strategy usually
involves :
laminectomy
supplemented by
posterior fusion
An HS, et al. Spine 1994
Mazel C, et al. Spine 2004
32. A posterior procedure
may also be used for:
resection of tumors
involving the anterior
elements,
such as through a
transpedicular approach
or
costotransversectomy,
thus avoiding the more
morbid anterior approaches
Le Hoang, et al Neurosurg Focus 2003
33. En bloc resection
of local extension
from tumors like a
pancoast tumor often
involves
vertebrectomy,
and may include
an anterior approach
Mazel C, et al. Spine 2004
Mazel C, et al. Spine 2004
35. Osteomyelitis
TBC
TBC has a predilection to the
upper lobe of the lung; therefore,
spread to the CTJ is not
uncommon.
Instability occurs when there is
destruction of the anterior column.
Progressive kyphosis occurs as the
mobile cervical spine topples over
the thoracic spine
Mihir B, et al Spine 2006
TTBBCC
36. Ankylosing spondylitis
It predisposes the spine to
traumatic fractures and
dislocation as well as to
several deformities
Fox MW, et al. J Neurosurg 1993
37. Iatrogenic instability
multilevel laminectomy in the
cervical spine in children
predisposes the CTJ to instability
laminectomy across the CTJ
without instrumentation tends to
introduce instability to the CTJ
Yasuoka S, et al J Neurosurg
An HS, et al Spine
41. Standard midline
posterior approach
is useful for :
A laminectomy for
decompression
or for
Tumors located in the
posterior column.
Decompressive
laminectomy
50. CCeerrvviiccootthhoorraacciicc JJuunnccttiioonn
If more lateral access is
needed:
a costotransversectomy
or
lateral extracavitary
approach can be used
An HS, et al Spine 1994
Kaya RA, et al. Surg Neurol 2006
52. In a costotransversectomy,
a midline or paramedian
incision is used and the rib
head and costotransverse
joint are resected
Sometimes, the superior or
inferior pedicles may be
removed
Vaccaro et al Principles and practice of spine
surgery. 2003
53. The lateral extracavitary
approach is used for
limited access to the anterior
column and if the patient
cannot tolerate a
thoracotomy or anterior
approaches
Vaccaro et al Principles and practice of spine
surgery. 2003
54. In this case,
a short incision
is made over the rib at
the desired level, and the
rib head is removed,
along with the pedicle
and the posterior-lateral
vertebral body
Vaccaro et al Principles and practice of spine
surgery. 2003
65. The experience with
lateral mass and
pedicle screw fixation
across the CTJ has
been fairly positive.
Heller G et al JBJS (am), 1996
Kotani Y, et al, Spine, 1994
66. New constructs using a
screw-rod system have
been developed in the
past 10 years.
Kreshak JL, et al. Spine 2002
Mazel C, et al. Spine 2004
Rhee JM, et al Spine 2005
Jeanneret B. Eur Spine J 1996
67. Biomechanically, these
constructs provide
significant stabilization to
the CTJ in cadaver studies
Ulrich C et al, Eur. Spine, 2001
Kreshak JL, et al. Spine 2002
68. The pedicle screw fixation is
superior compared with
lateral mass fixation at C7 in
all biomechanical tests
Biomechanical studies have
yielded important information
about the number of levels
that should be included and
also the relative strength of
anterior and posterior
fixation.
This can be partially corrected
by adding another level of
fixation with lateral mass
screws at C6
Ulrich C, eta, Spine (sup), 1991
Mazel C, et al. Spine 2004
Le Hoang, et al Neurosurg Focus 2003
Chapman JR, et al. J Neurosurg 1996
69. Compared with the
intact spine, posterior
instrumentation with a
screw-rod system can
restore almost 100%
of the strength in a
two column but not a
three-column injury
Kreshak JL, et al. Spine 2002
70. Although some authors have used
only posterior fixation in trauma
that included the anterior column,
such as burst fracture,
biomechanical studies have
shown that in a three-column
injury, posterior fixation is not
sufficient to restore the stiffness to
the level of intact spine
It is therefore believed that a three-column
injury is probably better
treated with anterior and
posterior fixation.
Chapman JR, et al J Neurosurg 1996
Sapkas G, et al Eur Spine J 1999
Kreshak JL, et al. Spine 2002
71. In tumor cases, is
recommend that the
fusion be extended
three levels above and
three levels below if a
vertebrectomy is
performed.
Mazel C, et al. Spine 2004
72. The use of pedicle screws and lateral mass
fixation at the CTJ is safe.
In one study, breaching of
the pedicle was found on
postoperative CT scans in
9% of the screws when
inserted without any
guidance, but the incidence
was reduced to 3% when a
navigation system was used
Richter M. Orthop Traumatol 2005
73. The incidence of vascular
injury is extremely rare, and
radiculopathy is estimated
to be in the range of
1% to 2%
Deen HG, et al Spine J 2003
Mazel C, et al. Spine 2004