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C1 Posterior Arch Flare Point: A Useful Landmark for Fluoroscopically Guided C1–2 Puncture

Overview of attention for article published in American Journal of Neuroradiology, June 2018
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (86th percentile)
  • High Attention Score compared to outputs of the same age and source (88th percentile)

Mentioned by

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22 tweeters

Citations

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1 Dimensions

Readers on

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4 Mendeley
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Title
C1 Posterior Arch Flare Point: A Useful Landmark for Fluoroscopically Guided C1–2 Puncture
Published in
American Journal of Neuroradiology, June 2018
DOI 10.3174/ajnr.a5706
Pubmed ID
Authors

M.E. Peckham, L.M. Shah, A.C. Tsai, E.P. Quigley, J. Cramer, T.A. Hutchins

Abstract

The C1-2 intrathecal puncture is routinely performed when lumbar puncture is not feasible. Usage has steadily decreased in part because of the perceived high risk of injury to the cervical cord. Up to this point, vague fluoroscopic guidelines have been used, creating uncertainty about the actual needle location relative to the spinal cord. We present a novel osseous landmark to aid in C1-2 intrathecal puncture, corresponding to the posterior spinal cord margin on lateral fluoroscopic views. This landmark, which we have termed the "flare point," represents the triangular "flaring" of the posterior C1 arch at its junction with the anterior arch. Cervical spine CT myelograms were reviewed. High-resolution axial images were reformatted into the sagittal plane, and maximum-intensity-projection images were created to simulate a lateral fluoroscopic view. Tangential lines were drawn along the superior cortices of the anterior and posterior C1 arches, with the point of intersection used to approximate the flare point. Chart review was performed for all C1-2 punctures using the flare point technique in the past 3 years. Forty-two cervical myelograms were reviewed. The average flare point was 0.2 ± 0.5 mm posterior to the dorsal spinal cord margin. In 37/42 subjects, the flare point was localized posterior to the spinal cord. Targeting by means of the flare point was used in 16 C1-2 punctures without complications. The C1 posterior arch flare point accurately approximates the dorsal spinal cord margin on myelography. Targeting between the flare point and the spinolaminar line, at the mid-C1-2 interspace, allows safe and optimal needle positioning.

Twitter Demographics

The data shown below were collected from the profiles of 22 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 4 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 4 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 1 25%
Student > Postgraduate 1 25%
Lecturer > Senior Lecturer 1 25%
Unknown 1 25%
Readers by discipline Count As %
Medicine and Dentistry 2 50%
Unknown 2 50%

Attention Score in Context

This research output has an Altmetric Attention Score of 16. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 July 2020.
All research outputs
#1,299,848
of 16,024,812 outputs
Outputs from American Journal of Neuroradiology
#195
of 3,953 outputs
Outputs of similar age
#36,978
of 278,583 outputs
Outputs of similar age from American Journal of Neuroradiology
#9
of 78 outputs
Altmetric has tracked 16,024,812 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 91st percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 3,953 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.1. This one has done particularly well, scoring higher than 95% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 278,583 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 78 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 88% of its contemporaries.