椎动脉高跨和颈2椎板螺钉

椎动脉高跨和颈2椎板螺钉（High-RidingVertebralArtery/C2laminarscrews）俞武良2018-3-21C2pediclescrewvertebralartery(VA)VAinjury•4.1%to8.2%forposterioratlantoaxialtransarticularscrewfixation•5.3%–21%forC2pedicularscrew•FactorscontributetoVAinjury–VAgroove(VAG)anomaly•high-ridingvertebralartery14.5%–18%•narrowC2pedicle9.5%–32%–insertionofthescrewextremelyclosetotheVA•HRVAdefinedashavinganisthmusheightof≤5mmand/oraninternalheightof≤2mmonthesagittalimage2–3mmlateraltothecorticalborderofthespinalcanalatC2.•narrowC2pedicledefinedashavingthelargestpedicularwidthof≤4mmontheaxialimagehigh-ridingvertebralartery(HRVA)•椎动脉在枢椎上关节突的下方有一个向外的弯曲,如果椎动脉弯曲过于向后、内或位置过高,则提示枢椎峡部狭窄,这种情况称为椎动脉高跨C2laminarscrew(Wright2004)我们最近的病例