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