{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T06:13:43Z","timestamp":1762236823867,"version":"build-2065373602"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Axial lamina screw placement is a new posterior cervical fixation technique that differs from the previously described transarticular screw placement and pedicle screw placement in terms of the risk of causing damage to the vertebral artery. However, the previously reported laminar screw placement technique carries the risk of causing damaging to the screws in the inner wall of the vertebral plate and screw protrusion into the spinal canal. To address this issue, our center has designed a screw placement assistant tool to help surgeons safely insert screws.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The medical records of 6 patients with upper cervical spine injuries who were admitted to Xi'an Honghui Hospital between March 2021 and February 2022 were retrospectively analyzed to assess the patients' postoperative recovery. Self-designed screw placement assistants were used to insert double cortical laminar screws for posterior cervical fixation. Computed tomography (CT) scanning was performed to observe screw placement after surgery. The clinical and postoperative recovery data of the patients were reviewed, and the clinical efficacy of aids for bicortical screw placement in the axial (C2) vertebral lamina were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All patients were followed up for 9\u201316 months, with an average of 11.5 months. The fractures were satisfactorily fixed and healed. No patients experienced wound infection, internal fixation failure, or secondary surgery. Postoperative CT scans showed that a total of 12 C2 bicortical lamina screws were implanted in 6 patients. The axial lamina screws were well positioned and located in the center of the axial lamina, without any deviation or detachment. There were also no cases in which screws penetrated the medial cortical bone of the lamina or protruded into the spinal canal. No patients experienced vertebral artery injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>C2 laminar screw placement, as a technique for posterior fixation of the high cervical spine, can be a good choice when transarticular screw and pedicle screw placement are difficult. Our designed screw placement assistance tool can help surgeons safely and accurately insert bicortical cross screws into the axial vertebral lamina, avoiding screw damage to the inner wall of the lamina and spinal canal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1648329","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T06:10:20Z","timestamp":1762236620000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Application of bilateral crossing C2 laminar screws and screw placement assistant tools for upper cervical spine fixation: technology note"],"prefix":"10.3389","volume":"12","author":[{"given":"Hongfei","family":"Qi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoxuan","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengcheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1007\/s00701-009-0198-4","article-title":"Posterior atlanto-axial fixation with polyaxial C1 lateral mass screws and C2 pars screws","volume":"151","author":"Payer","year":"2009","journal-title":"Acta Neurochir (Wien)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/00002517-199212000-00012","article-title":"Primary posterior fusion C1\/2 in odontoid fractures: indications, technique, and results of transarticular screw fixation","volume":"5","author":"Jeanneret","year":"1992","journal-title":"J Spinal Disord"},{"key":"B3","first-page":"6","article-title":"Transarticular fixation of C1\u2013C2: a multicenter retrospective study","volume":"71","author":"Suchomel","year":"2004","journal-title":"Acta Chir Orthop Traumatol Cech"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1097\/00006123-200212000-00004","article-title":"Atlantoaxial fixation using plate and screw method: a report of 160 treated patients","volume":"51","author":"Goel","year":"2002","journal-title":"Neurosurgery"},{"key":"B5","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1302\/0301-620X.79B5.0790820","article-title":"Variation of the groove in the axis vertebra for the vertebral artery. Implications for instrumentation","volume":"79","author":"Abou Madawi","year":"1997","journal-title":"J Bone Joint Surg Br"},{"key":"B6","doi-asserted-by":"publisher","first-page":"2301","DOI":"10.1097\/00007632-199610010-00028","article-title":"Anatomic consideration of C2 pedicle screw placement","volume":"21","author":"Benzel","year":"1996","journal-title":"Spine (Phila Pa 1976)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"E513","DOI":"10.1097\/01.brs.0000224516.29747.52","article-title":"Comparison of the anatomical risk for vertebral artery injury associated with the C2-pedicle screw and atlantoaxial transarticular screw","volume":"31","author":"Yoshida","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"B8","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1097\/00024720-200404000-00014","article-title":"Posterior C2 fixation using bilateral, crossing C2 laminar screws: case series and technical note","volume":"17","author":"Wright","year":"2004","journal-title":"J Spinal Disord Tech"},{"key":"B9","first-page":"311","article-title":"Cervical crossing laminar screws: early clinical results and complications","volume":"61","author":"Wang","year":"2007","journal-title":"Neurosurgery"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1007\/s00701-009-0459-2","article-title":"Modification of Wright\u2019s technique for C2 translaminar screw fixation: technical note","volume":"151","author":"Kabir","year":"2009","journal-title":"Acta Neurochir (Wien)"},{"key":"B11","doi-asserted-by":"publisher","first-page":"656","DOI":"10.1016\/j.spinee.2007.06.008","article-title":"Modification of Wright\u2019s technique for placement of bilateral crossing C2 translaminar screws: technical note","volume":"8","author":"Jea","year":"2008","journal-title":"Spine J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"409","DOI":"10.3171\/spi.2005.3.5.0409","article-title":"Translaminar rigid screw fixation of the axis. Technical note","volume":"3","author":"Wright","year":"2005","journal-title":"J Neurosurg Spine"},{"key":"B13","doi-asserted-by":"publisher","first-page":"159","DOI":"10.3349\/ymj.2015.56.1.159","article-title":"Feasibility of translaminar screw placement in Korean population: morphometric analysis of cervical spine","volume":"56","author":"Ji","year":"2015","journal-title":"Yonsei Med J"},{"key":"B14","doi-asserted-by":"publisher","first-page":"279","DOI":"10.2106\/00004623-197860030-00001","article-title":"Atlanto-axial arthrodesis by the wedge compression method","volume":"60","author":"Brooks","year":"1978","journal-title":"J Bone Joint Surg Am"},{"key":"B15","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1097\/00007632-199205000-00003","article-title":"Biomechanical evaluation of four different posterior atlantoaxial fixation techniques","volume":"17","author":"Grob","year":"1992","journal-title":"Spine (Phila Pa 1976)"},{"key":"B16","doi-asserted-by":"publisher","first-page":"634","DOI":"10.3171\/jns.1998.88.4.0634","article-title":"Vertebral artery injury in C1\u20132 transarticular screw fixation: results of a survey of the AANS\/CNS section on disorders of the spine and peripheral nerves. American Association of Neurological Surgeons\/Congress of Neurological Surgeons","volume":"88","author":"Wright","year":"1998","journal-title":"J Neurosurg"},{"key":"B17","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1097\/00007632-199603150-00005","article-title":"Anatomic consideration of C2 pedicle screw placement","volume":"21","author":"Ebraheim","year":"1996","journal-title":"Spine (Phila Pa 1976)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"2317","DOI":"10.1097\/00007632-199610150-00003","article-title":"Anatomic consideration of transpedicular screw placement in the cervical spine. An analysis of two approaches","volume":"21","author":"Miller","year":"1996","journal-title":"Spine (Phila Pa 1976)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1097\/00007632-199610150-00003","article-title":"Anatomic study of the axis for surgical planning of transarticular screw fixation","volume":"408","author":"Igarashi","year":"2003","journal-title":"Clin Orthop Relat Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1097\/00007632-199901150-00002","article-title":"The quantitative anatomy of the laminas of the spine","volume":"24","author":"Xu","year":"1999","journal-title":"Spine (Phila Pa 1976)"},{"key":"B21","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1177\/2192568220947054","article-title":"Bicortical laminar screws for posterior fixation of subaxial cervical spine: a radiologic analysis with computed tomography images","volume":"12","author":"Park","year":"2022","journal-title":"Global Spine J"},{"key":"B22","first-page":"343","article-title":"Translaminar versus pedicle screw fixation of C2: comparison of surgical morbidity and accuracy of 313 consecutive screws","volume":"64","author":"Parker","year":"2009","journal-title":"Neurosurgery"},{"key":"B23","first-page":"59","article-title":"Pediatric atlantoaxial fixation with bilateral, crossing C-2 translaminar screws. Technical note","volume":"104","author":"Leonard","year":"2006","journal-title":"J Neurosurg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1227\/01.NEU.0000197222.05299.31","article-title":"Biomechanical comparison of four C1 to C2 rigid fixative techniques: anterior transarticular, posterior transarticular, C1 to C2 pedicle, and C1 to C2 intralaminar screws","volume":"58","author":"Lapsiwala","year":"2006","journal-title":"Neurosurgery"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1648329\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T06:10:21Z","timestamp":1762236621000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1648329\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,4]]},"references-count":24,"alternative-id":["10.3389\/fsurg.2025.1648329"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1648329","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,4]]},"article-number":"1648329"}}