C2 Lateral Mass Vertebrae Anthropometry for Evaluating C2 Straight Lateral Mass Screw Fixation

Background: The cervical vertebra is an important vertebra as there are blood vessels in its surroundings from the brain to the entire vertebrae. Cervical injury has the most fatal consequences when it occurs as high as C1-C2. If instability occurs in the C1-C2 vertebrae and atlantoaxial joints, the procedure of surgical techniques include cervical arthrodesis or spinal fusion. C2 straight lateral mass fixation is one technique that can be used for fixation in patients with spinal cord compression and anomalous vertebral artery by inserting shorter screws in the lateral mass of the C2 vertebrae from the posterior direction. There have been not many references similar to the present study of anatomy to discover the screw characteristics needed in this technique.

Aim: This study aimed to identify the length of the lateral mass in the C2 vertebra for the purposes of the C2 straight lateral mass screw fixation technique.

Method: This research was an observational descriptive study with cross sectional design that observed the results of cervical CT-Scan. Observation was made using the RadiAnt DICOM Viewer application and measurements were based on a sagittal cross section. The length was measured from the posterior parallel to the posterior longitudinal ligament (PLL). The initial mean was measured on the right and left side; afterwards, the final mean is the total mean of both sides.

Result: From 10 samples, there were mean long lateral masses of C2 vertebrae on the right side of 13.511 ± 1.081 millimeters, the left side of 13.444 ± 1.396 millimeters, and the final mean of 13.48 ± 1,216 millimeters. It was rounded to an average of 13.5 ± 1.2 millimeters.

Discussion: The line parallel to the posterior longitudinal ligament (PLL) is more posterior than the line parallel to the foramen transversum wall which causes the measured length to be shorter. This is useful for the C2 straight lateral mass screw technique as it avoids the possibility of lesions in the vertebral artery.

Conclusion: The average lateral mass length in the population of Surabaya is 13.5 ± 1.2 millimeters.