The Use of C1 Lateral Mass Screws in Complex Cervical Spine Surgery: Indications, Techniques, and Outcome in a Prospective Consecutive Series of 25 Cases
Why this work is in the frame
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Bibliographic record
Abstract
OBJECTIVES: Direct C1 lateral mass/C2 pars or pedicle screw fixation has been recently proposed as an alternative method to C1-C2 transarticular screw fixation. Although this method seems attractive, there are currently limited clinical data on the use of this technique for multilevel fixation including complex craniocervical reconstructions. The objectives of this study were to assess the safety and the clinical/radiographic outcomes in patients undergoing cervical spine surgery using C1 lateral mass screws (C1-LMS). METHODS: A prospectively accrued database was reviewed to determine initial presentation, etiology, operations, complications, and clinical/radiologic outcomes. RESULTS: Twenty-five patients with a mean age of 56 underwent fixation with C1-LMS. Mean follow-up was 12 months. The indications for using C1-LMS instead of C1-C2 transarticular screws were: unfavorable bony or vascular anatomy, tumor destruction, thoracic kyphosis or cervical hyperlordosis, inability to reduce the C1-C2 dislocation intraoperatively and or surgeon preference. Satisfactory stability was achieved in all cases with no neurologic or vascular complications. In one case, the C1 screws breached the medial cortex. Three patients developed transient postoperative C2 neuralgia. One patient had an extended stay in ICU due to respiratory issues. CONCLUSIONS: On the basis of our experience, proficiency with the use of C1-LMS screw fixation greatly enhances the ability to manage complex atlantoaxial or craniocervical pathologies with low morbidity. This technique should be considered an excellent adjunct or alternative to transarticular screw fixation.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it