Determining anatomically-safe corridors for placement of lateral mass screws in the first cervical vertebra of the Emirati population – a CT study

Scientific Reports, 2025 · DOI: https://doi.org/10.1038/s41598-025-85181-1 · Published: January 1, 2025

Simple Explanation

The study focuses on identifying safe and effective methods for placing screws in the first cervical vertebra (C1) of the Emirati population to stabilize the craniovertebral junction. The research uses CT scans to determine the ideal screw dimensions, entry points, safe bony corridors, and trajectories for lateral mass screw placement, considering the unique anatomical variations within the Emirati population. The goal is to provide surgeons with precise anatomical landmarks to minimize the risk of injury to nearby neurovascular structures during C1 lateral mass screw fixation.

Study Duration

12-month study period

Participants

160 adults (80 Male, 80 Female) - Indigenous Emirati population

Evidence Level

Not specified

Key Findings

1
The study found that a screw entry at the center of the lateral mass, below its junction with the posterior arch, allowed straight screws of lengths 20 mm and 19.5 mm in Emirati males and females, respectively.
2
A medial angulation of 20° in males and 15° in females allowed maximum bone purchase, improving the stability of the screw placement.
3
The mean critical width between the foramen transversarium and the vertebral canal was 7.6 mm in males and 6.8 mm in females, safely permitting screws of 4.0 mm width.

Research Summary

This study used CT scans of 160 Emirati patients to determine the optimal screw dimensions, entry points, bony corridors, and screw trajectories for C1 lateral mass screw placement. The research identified two commonly used entry points (A and B) and provided detailed measurements for safe screw placement, considering gender-specific anatomical differences. The findings recommend specific medial and cephalic angulations, screw lengths, and widths to minimize the risk of injury to neurovascular structures during C1 lateral mass fixation in the Emirati population.

Practical Implications

Improved Surgical Precision

Pre-operative knowledge of the ideal screw dimensions and trajectories will help surgeons perform C1 lateral mass screw fixation with greater precision.

Reduced Risk of Neurovascular Injury

The study's findings provide specific anatomical landmarks and safe corridors, minimizing the risk of injury to the vertebral artery, spinal cord, and other neurovascular structures.

Enhanced Biomechanical Stability

The recommended medial angulations and screw lengths ensure better bone purchase and improve the overall biomechanical stability of the craniovertebral junction.

Study Limitations

1
The study only included healthy adults with no fractures or degenerative processes, potentially limiting the generalizability to patients with osteoporosis or other degenerative diseases.
2
The study focused exclusively on the Emirati population, and the findings may not be directly applicable to other ethnic groups without further research.
3
The study relied on CT imaging, and variations may still exist, requiring surgeons to ensure accuracy on a case-by-case basis.

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