Details

Autor(en) / Beteiligte

• Ortega-Balderas, Jessica A.
• Sada-Treviño, Miguel A.
• Barrera-Flores, Francisco J.
• Zárate-Garza, Pablo P.
• Lugo-Guillén, Roberto A.
• Gómez-Sánchez, Arnulfo
• Pinales-Razo, Ricardo
• Elizondo-Riojas, Guillermo
• Guzmán-López, Santos
• Elizondo-Omaña, Rodrigo E.

Titel

Avoiding iatrogenic injuries to the vertebral artery: A morphometric study of the vertebral artery-free dissection area

Ist Teil von

• Clinical neurology and neurosurgery, 2020-09, Vol.196, p.106001-106001, Article 106001

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2020

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• •Estimated surgical safety area avoiding the vertebral artery is provided.•Dissection area is significantly smaller in women.•This data may assist in the pre-surgical assessment by imaging studies. To determine the area of a safety window that excludes the vertebral artery for the safe access of the occipital condyle screws during occipitocervical fixation. This study included 138 cervical computed tomography angiograms. Six measurements per side were made in each imaging study. These measurements are from the vertebral artery to (A) the mastoid process, (B) the mastoid incisura, (C) the posterior condylar fossa, (D) the occipital condyle in its midline, and (E) the medial border of the condyle. We also measured from the tip of the mastoid process to the lower border of the occipital condyle on its lateral side (F). A total of 276 areas from 138 individuals were included, of which 51.4 % were men. The mean age was 54.2 ± 18.63 years. The mean variable measurements (mm) for all the population were 21 ± 4, 16 ± 3, 6 ± 2, 3 ± 2, 2 ± 1 and 35 ± 4 for variables A-F, respectively. We found significant differences between sex when we compared measurements A (p = 0.003), C (p = 0.001), D (p = 0.000) and F (p = 0.000). The incidence rate of dominance for the vertebral artery was 18.8 % and 30.4 % for right and left respectively. Women had significantly smaller measures than men. This could indicate a higher risk of iatrogenic injury secondary to a smaller vertebral artery-free area. Results may guide surgeons in the pre-surgical planning aiming to reduce the risk of iatrogenic injuries to the vertebral artery.