Biomechanical evaluation of In-Out-In pedicle screws for atlantoaxial posterior fixation in the presence of high-riding vertebral artery and narrow C2 pedicles: a finite element analysis

Abstract Introduction In patients with high-riding vertebral artery (HRVA) and narrow pedicles, placement of C2 pedicle screws carries a significant risk of vertebral artery injury. The in-out-in pedicle screws (IOIPS) technique offers an alternative posterior fixation strategy. However, the biomech...

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Main Authors: Xiong-han Lian, Wen He, Wen-jia Sun, Xu-chao Lin, Huo-huo Xue, Zhi-feng Zeng, Yu-fan Chen, Ming-di Chen, Feng-guang Wei, Zhi-qiang Wang, Hong-liang Ruan, Zi-qi Luo, Xiang-ting Chen, Xin Chen, Jing-lai Xue
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Journal of Orthopaedic Surgery and Research
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Online Access:https://doi.org/10.1186/s13018-025-06095-2
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