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Start date: 2010End date: 2019Type: search.filters.itemtype.ReviewHas files: NoAuthor: search.filters.author.Konya, DenizSubject: search.filters.subject.Biomechanics

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    Posterior Rigid Instrumentation of C7: Surgical Considerations and Biomechanics at the Cervicothoracic Junction. A Review of the Literature
    (ELSEVIER SCIENCE INC, 2018) Bayoumi, Ahmed B.; Efe, Ibrahim E.; Berk, Selim; Kasper, Ekkehard M.; Toktas, Zafer Orkun; Konya, Deniz; Bahcesehir University; Free University of Berlin; Humboldt University of Berlin; Charite Universitatsmedizin Berlin; Harvard University; Harvard University Medical Affiliates; Beth Israel Deaconess Medical Center; Harvard Medical School
    BACKGROUND: The cervicothoracic junction is a challenging anatomic transition in spine surgery. It is commonly affected by different types of diseases that may significantly impair stability in this region. The seventh cervical vertebra (C7) is an atypical cervical vertebra with unique anatomic features compared to subaxial cervical spine (C3 to C6). C7 has relatively broader laminae, larger pedicles, smaller lateral masses, and a long nonbifid spinous process. These features allow a variety of surgical methods for performing posterior rigid instrumentation in the form of different types of screws, such as lateral mass screws, pedicle screws, transfacet screws, and intralaminar screws. Many biomechanical studies on cadavers have evaluated and compared different types of implants at C7. METHODS: We reviewed PubMed/ Medlineby using specific combinations of keywords to summarize previously published articles that examined C7 posterior rigid instrumentation thoroughly in an experimental fashion on patients or cadavers with additional descriptive radiologic parameters for evaluation of the optimum surgical technique for each type. RESULTS: A total of 44 articles were reported, including 22 articles that discussed anatomic considerations (entry points, sagittal and axial trajectories, and features of screws) and another 22 articles that discussed the relevant biomechanical testing at this transitional region if C7 was directly involved in terms of receiving posterior rigid implants. CONCLUSIONS: C7 can accommodate different types of screws, which can provide additional benefits and risks based on availability of bony purchase, awareness of surgical technique, biomechanics, and anatomic considerations.
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    Posterior Rigid Instrumentation of C7: Surgical Considerations and Biomechanics at the Cervicothoracic Junction. A Review of the Literature
    (Elsevier Inc. [email protected], 2018) Bayoumi, Ahmed B.; Efe, Ibrahim Efecan; Berk, Selim; Kasper, Ekkehard Matthias; Toktaş, Zafer Orkun; Konya, Deniz; Bayoumi, Ahmed B., Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Efe, Ibrahim Efecan, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey, Department of Neurosurgery, Charité – Universitätsmedizin Berlin, Berlin, Germany; Berk, Selim, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Kasper, Ekkehard Matthias, Division of Neurosurgery, Harvard Medical School, Boston, United States; Toktaş, Zafer Orkun, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey; Konya, Deniz, Department of Neurosurgery, Bahçeşehir Üniversitesi, Istanbul, Turkey
    Background: The cervicothoracic junction is a challenging anatomic transition in spine surgery. It is commonly affected by different types of diseases that may significantly impair stability in this region. The seventh cervical vertebra (C7) is an atypical cervical vertebra with unique anatomic features compared to subaxial cervical spine (C3 to C6). C7 has relatively broader laminae, larger pedicles, smaller lateral masses, and a long nonbifid spinous process. These features allow a variety of surgical methods for performing posterior rigid instrumentation in the form of different types of screws, such as lateral mass screws, pedicle screws, transfacet screws, and intralaminar screws. Many biomechanical studies on cadavers have evaluated and compared different types of implants at C7. Methods: We reviewed PubMed/Medline by using specific combinations of keywords to summarize previously published articles that examined C7 posterior rigid instrumentation thoroughly in an experimental fashion on patients or cadavers with additional descriptive radiologic parameters for evaluation of the optimum surgical technique for each type. Results: A total of 44 articles were reported, including 22 articles that discussed anatomic considerations (entry points, sagittal and axial trajectories, and features of screws) and another 22 articles that discussed the relevant biomechanical testing at this transitional region if C7 was directly involved in terms of receiving posterior rigid implants. Conclusions: C7 can accommodate different types of screws, which can provide additional benefits and risks based on availability of bony purchase, awareness of surgical technique, biomechanics, and anatomic considerations. © 2018 Elsevier B.V., All rights reserved.