Morphometric analysis by computed tomography of the entry point and trajectory for safe screw fixation surgery of the C2 pedicle in the Turkish population according to age and sex.

PURPOSE: This study was conducted to evaluate the morphometric of the C2 vertebra in relation to screw fixation surgery and to establish standards for safe entry points and trajectories for pedicle screws. METHODS: Computed tomography images of 323 individuals, comprising 163 females and 160 males aged 20-59 years, were used in the study. In the retrospective study, pedicle length (PL), pedicle thickness (PT), pedicle height (PH), pedicle angle (PA), pedicle-lamina angle (PLA), sagittal angle (SA), and ideal entry length (EL) parameters were evaluated on the right (R) and left (L) sides. The measured parameters were analysed in a total of 4 groups divided into age deciles. RESULTS: As a result of our study, it was found that PL, PH, and EL parameters were higher in males compared to females on both sides (p < 0.05). It was found that RPL and RPA parameters were smaller than LPL and LPA, respectively, while the RPLA parameter was larger than the LPLA parameter (p < 0.05). In males, RPA, RSA, and LSA parameters were higher in group 1 than in group 4 (p < 0.05). In females, RPH and LPH parameters were found to be the largest in group 1 (p < 0.05). CONCLUSION: It has been observed that C2 morphometry is greater in male and decreases with age. These findings highlight the need for individual assessment in surgical planning and the importance of taking age and sex into account for clinical safety in interventional procedures such as screw placement.