Publication: Aksis (C2) vertebranın mikrocerrahi anatomisi
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2024
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Amaç: C2 (Axis) vertebra anatomik olarak diğer servikal vertebralardan farklı özellikler gösterir. Bu tez çalışmasında, kadavra örnekleri kullanılarak C2 vertebra mikrocerrahi anatomisinin incelenmesi, C2 pedikül ve C1-C2 transartiküler vidaların vertebral arter mobilizasyonu ile yerleştirilmesi ve yeni C2 inferior korpus vida yerleştirme tekniği gösterilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışmada, bir üniversitenin Araştırma Etik Komitesi'nin izni ve kararı ile on iki adet yetişkin kadavra spesmeni ve iki adet yetişkin kuru kadavra C2 kemiği kullanılmıştır. Ardından, adım adım kas diseksiyonu gerçekleştirilmiş ve kadavraların C2 vertebraları cerrahi mikroskop ile ortaya çıkarılmıştır. Her örnek ve diseksiyonun tüm aşamaları fotoğraflarla kaydedilmiştir. Kadavra diseksiyonlarından sonra üç farklı teknikle vida yerleştirme yapılmıştır. Son olarak, floroskopi ile radyolojik görüntüleme yapılmıştır.Bulgular: C2 vertebra kemiği ortaya çıkarıldı ve vertebral arterin üzerindeki kemik çatı açılarak vertebral arter inferiora mobilize edildi. Bu adımdan sonra, C2 vertebraya posterior yaklaşımla farklı vida yerleştirme teknikleri uygulandı ve fotoğraflandı. Sonuç: Vertebral arterin mobilizasyonu sonrasında C2 pedikül, C1-2 transartiküler ve C2 inferior korpus vidalarının daha güvenli bir şekilde yerleştirmesi mümkündür. Bu çalışma, bu tekniklerin hepsini bir kadavra üzerinde ilk kez göstermeyi ve C2 vertebra anatomisini anlamayı amaçlamıştır.
Title of Thesis: Microsurgical Anatomy of Axis (C2) Vertebrae Student Name, Surname: Ferhat HarmanSupervisor Name: Prof. Adnan DağçınarProgram Name: Neurological Science PhD ProgramObjective: C2 (Axis) vertebra is anatomically different from other cervical vertebrae. In this thesis, it is aimed to investigate the microsurgical anatomy of C2 vertebra using cadaveric specimens, to place C2 pedicle and C1-C2 transarticular screws with vertebral artery mobilization and to demonstrate a new C2 inferior corpus screw placement technique.Materials and Methods: In this study, twelve adult cadaveric specimens and two adult dry cadaveric C2 bones were used with the permission and decision of an University Research Ethics Committee. Then, step by step muscle dissection was performed and the C2 vertebrae of the cadavers were exposed with a surgical microscope. Each specimen and all stages of dissection were recorded with photographs. After cadaver dissections, screw placement was performed with three different techniques. Finally, radiological imaging with fluoroscopy was performed.Results: The C2 vertebral bone was exposed and the bony roof over the vertebral artery was removed, and the vertebral artery was mobilized inferiorly. After this step, different screw placement techniques were applied to the C2 vertebra with a posterior approach and photographed.Conclusion: After the mobilization of the vertebral artery, safer placement of C2 pedicle, C1-2 transarticular and C2 inferior corpus screws is possible. This study aimed to demonstrate all these techniques for the first time on a cadaver and to understand the anatomy of the C2 vertebra.
Title of Thesis: Microsurgical Anatomy of Axis (C2) Vertebrae Student Name, Surname: Ferhat HarmanSupervisor Name: Prof. Adnan DağçınarProgram Name: Neurological Science PhD ProgramObjective: C2 (Axis) vertebra is anatomically different from other cervical vertebrae. In this thesis, it is aimed to investigate the microsurgical anatomy of C2 vertebra using cadaveric specimens, to place C2 pedicle and C1-C2 transarticular screws with vertebral artery mobilization and to demonstrate a new C2 inferior corpus screw placement technique.Materials and Methods: In this study, twelve adult cadaveric specimens and two adult dry cadaveric C2 bones were used with the permission and decision of an University Research Ethics Committee. Then, step by step muscle dissection was performed and the C2 vertebrae of the cadavers were exposed with a surgical microscope. Each specimen and all stages of dissection were recorded with photographs. After cadaver dissections, screw placement was performed with three different techniques. Finally, radiological imaging with fluoroscopy was performed.Results: The C2 vertebral bone was exposed and the bony roof over the vertebral artery was removed, and the vertebral artery was mobilized inferiorly. After this step, different screw placement techniques were applied to the C2 vertebra with a posterior approach and photographed.Conclusion: After the mobilization of the vertebral artery, safer placement of C2 pedicle, C1-2 transarticular and C2 inferior corpus screws is possible. This study aimed to demonstrate all these techniques for the first time on a cadaver and to understand the anatomy of the C2 vertebra.
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C2 anatomisi, yüksek yerleşimli vertebral arter, C2 vida yerleştirme, aksis anatomisi, vertebral arter mobilizasyonu C2 anatomy, high-riding vertebral artery, C2 screw placement, axis anatomy, mobilization of vertebral artery