Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction
SUMMARY: The aim of this study was to establish safety ranges for the third vertebral artery segment (V3) for craneocervical procedures. Injury to V3 represents a potentially catastrophic complication. Its tortuous path and complex relationship with neighboring structures, increasing the risk. Ten m...
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Sociedad Chilena de Anatomía
2020
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oai:scielo:S0717-950220200001001402019-11-22Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical JunctionCruz-Elizondo,Miguel Angel de JesúsVillarreal-Silva,Eliud EnriqueQuiroga-Garza,AlejandroMorales-Gómez,Jesus AlbertoGonzález-Gómez,Marco AugustoElizondo-Omaña,Rodrigo EnriqueMartínez-Ponce-de-León,Angel RaymundoGuzmán-López,Santos Anatomy Vertebral artery V3 segment Cervical spine Spine surgery SUMMARY: The aim of this study was to establish safety ranges for the third vertebral artery segment (V3) for craneocervical procedures. Injury to V3 represents a potentially catastrophic complication. Its tortuous path and complex relationship with neighboring structures, increasing the risk. Ten male adult cadavers (20 vertebral arteries) with arterial infiltration of red latex were studied. The length, angles and anatomical measurements were obtained between the selected surgical landmarks and the portions of V3 segment. The horizontal portion has a length of 32.7 ± 3.6 mm with an angulation of 115.1 ± 8.3 degrees. The mean distances of the horizontal portion were: from the midline to the V3 groove of C1 posterior arch (24.7 ± 6.3 mm); from C1 pars interarticularis to the V3 distal loop of V3 (8.9 ± 1.4 mm). The vertical portion has a length 32.5 ± 5.6 mm with an angulation of the proximal loop of 113.6 ± 5.8 degrees. The mean distances between the C2 spinous process to the medial surface of the distal loop (43.8 ± 4.2 mm); from the C1-C2 joint to the V3 vertical portion (9.5 ± 1.5 mm); from C2 pars interarticularis to V3 in the C2 transverse foramen (6.5 ± 3.4 mm); from C2 pars interarticularis to V3 in the C1 transverse foramen (17.5 ± 4.5 mm). We reported four potential sites where V3 can be injured during four different surgical procedures: exposure of the posterior arch of C1, and pars interarticularis of C1 in the horizontal portion and exposure of the C1C2 joint, and placement of C1-C2 transarticular screws one in the vertical portion. We provide measurements of redundancy and safety ranges to reduce the risk of injury to the V3 segment during craniocervical surgical procedures.info:eu-repo/semantics/openAccessSociedad Chilena de AnatomíaInternational Journal of Morphology v.38 n.1 20202020-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022020000100140en10.4067/S0717-95022020000100140 |
| institution |
Scielo Chile |
| collection |
Scielo Chile |
| language |
English |
| topic |
Anatomy Vertebral artery V3 segment Cervical spine Spine surgery |
| spellingShingle |
Anatomy Vertebral artery V3 segment Cervical spine Spine surgery Cruz-Elizondo,Miguel Angel de Jesús Villarreal-Silva,Eliud Enrique Quiroga-Garza,Alejandro Morales-Gómez,Jesus Alberto González-Gómez,Marco Augusto Elizondo-Omaña,Rodrigo Enrique Martínez-Ponce-de-León,Angel Raymundo Guzmán-López,Santos Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| description |
SUMMARY: The aim of this study was to establish safety ranges for the third vertebral artery segment (V3) for craneocervical procedures. Injury to V3 represents a potentially catastrophic complication. Its tortuous path and complex relationship with neighboring structures, increasing the risk. Ten male adult cadavers (20 vertebral arteries) with arterial infiltration of red latex were studied. The length, angles and anatomical measurements were obtained between the selected surgical landmarks and the portions of V3 segment. The horizontal portion has a length of 32.7 ± 3.6 mm with an angulation of 115.1 ± 8.3 degrees. The mean distances of the horizontal portion were: from the midline to the V3 groove of C1 posterior arch (24.7 ± 6.3 mm); from C1 pars interarticularis to the V3 distal loop of V3 (8.9 ± 1.4 mm). The vertical portion has a length 32.5 ± 5.6 mm with an angulation of the proximal loop of 113.6 ± 5.8 degrees. The mean distances between the C2 spinous process to the medial surface of the distal loop (43.8 ± 4.2 mm); from the C1-C2 joint to the V3 vertical portion (9.5 ± 1.5 mm); from C2 pars interarticularis to V3 in the C2 transverse foramen (6.5 ± 3.4 mm); from C2 pars interarticularis to V3 in the C1 transverse foramen (17.5 ± 4.5 mm). We reported four potential sites where V3 can be injured during four different surgical procedures: exposure of the posterior arch of C1, and pars interarticularis of C1 in the horizontal portion and exposure of the C1C2 joint, and placement of C1-C2 transarticular screws one in the vertical portion. We provide measurements of redundancy and safety ranges to reduce the risk of injury to the V3 segment during craniocervical surgical procedures. |
| author |
Cruz-Elizondo,Miguel Angel de Jesús Villarreal-Silva,Eliud Enrique Quiroga-Garza,Alejandro Morales-Gómez,Jesus Alberto González-Gómez,Marco Augusto Elizondo-Omaña,Rodrigo Enrique Martínez-Ponce-de-León,Angel Raymundo Guzmán-López,Santos |
| author_facet |
Cruz-Elizondo,Miguel Angel de Jesús Villarreal-Silva,Eliud Enrique Quiroga-Garza,Alejandro Morales-Gómez,Jesus Alberto González-Gómez,Marco Augusto Elizondo-Omaña,Rodrigo Enrique Martínez-Ponce-de-León,Angel Raymundo Guzmán-López,Santos |
| author_sort |
Cruz-Elizondo,Miguel Angel de Jesús |
| title |
Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| title_short |
Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| title_full |
Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| title_fullStr |
Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| title_full_unstemmed |
Safety Ranges in V3 Segment of the Vertebral Artery for Surgical Procedures at the Craniocervical Junction |
| title_sort |
safety ranges in v3 segment of the vertebral artery for surgical procedures at the craniocervical junction |
| publisher |
Sociedad Chilena de Anatomía |
| publishDate |
2020 |
| url |
http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0717-95022020000100140 |
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