Background: Anterior occipital condyle screw (AOCS) could be a feasible alternative technique for occipitocervical fusion for reconstruction of craniovertebral junction. This study aimed to analyze the feasibility of AOCS.
Methods: The craniovertebral junction computed tomography (CT) scans of 40 adults were enrolled and imported into Mimics software. Then, the three-dimensional reconstruction digital model of craniovertebral junction was established to determine entry point, insertion angle, and screw’s trajectory. After AOCS insertion into ten human cadaver spine specimens, CT scans were performed to verify the location between screws and important structures.
Results: The optimal entry point was located caudally and medial to the ventral of occipital condyle. The optimal trajectory was in inclination angle (5.9°± 3.4°) in the sagittal plane and divergence angle (26.7°± 6.0°) in the axial plane with the screw length around 21.6± 1.2mm. None of the screws invaded the hypoglossal canal and vertebral artery in any of the specimens.
Conclusion: AOCS fixation is a feasible, novel technique for anterior craniovertebral junction reconstruction, and it could be an effective alternative operation for anterior reconstruction with titanium mesh cage.



中文翻译：

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前枕骨髁螺钉重建颅椎交界处的可行性：一项新技术的数字解剖和尸体研究

背景：前枕骨髁螺钉（AOCS）可能是一种可行的枕颈融合重建颅椎交界处的替代技术。本研究旨在分析AOCS的可行性。
方法：招募 40 名成人的颅脊交界计算机断层扫描 (CT) 扫描，并将其导入 Mimics 软件。然后，建立颅椎结合部三维重建数字模型，确定进入点、插入角度和螺钉轨迹。在将 AOCS 插入 10 个人体尸体脊柱标本后，进行 CT 扫描以验证螺钉和重要结构之间的位置。
结果：最佳进入点位于枕骨髁腹侧的尾部和内侧。最佳轨迹为矢状面倾角（5.9°±3.4°）和轴向面发散角（26.7°±6.0°），螺钉长度约为21.6±1.2mm。在任何标本中，螺钉均未侵入舌下管和椎动脉。
结论： AOCS固定是一种可行的、新颖的前路颅椎交界区重建技术，可作为钛网笼前路重建的有效替代手术。