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the patient is a 42-year-old man over the past year
he has suffered from increasing weakness and numbness in his legs and arms
a neurological examination confirms a cervical myelopathy
x-rays revealing unstable ass who don't already a malformation
the goal that the surgery is to achieve stabilize a shin and fusion
if the Atlanta axial segment a C-1 lateral mass
and sea tu parle screw fixation construct will be performed
because of the delicate trajectory the vertebral artery
the screws are inserted under 3d fluoroscopic navigation
in order to achieve optimal and save screw placement
and to reduce radiation exposure to the surgical team
the midline occipital cervical incision is performed
and the crime you were to rosa action is
exposed with this issue 1
arch here and is she to
vertebra you can see the joint between c2 and c3
the parse here on the left side
is exposed bulow guru does she do
her a productive speedy images
are acquirer you can see
the images year for the country were two runs on trim
and a pointer is calibrated
and used to similar way
the placement of the screws bear or productively so using the pointer
on the right side lateral mass
of issue 1 you can determine
the depp's trajectory and point of entry
of your emblems here on
the left side and the
point of entry is marked using a drill
same procedure for the parcels
she drew on the left side the four points
are martin C one and she did you here you can
precisely defined a trajectory and the depths of your implant
the you know part of the assimilation
is the depths of the directory