Objective      To study the feasibility of lower cervical spine anterior pedicle screw (APS) insertion and provide basis for its clinical application according to the preoperative APS related technological parameters.       Methods      Normal cervical spine specimens of 18 cadavers were carefully dissected to resect the surrounding tissue and to clearly expose the centrum antetheca. Following the CT sca

ns

three dimensional model was reconstructed by Mimics software. The imaging data to measured key parameters of anterior transpedicular screw fixation were also produced by Mimics software. The individual screw insertion parameters including intersection point (projective point of pedicle central axis on the centrum antetheca)

insertion angle (the inclined angle of screws in cross-sectional and sagittal plane of the centrum) and screws length of C

3

-C

7

were measured. Under direct vision

we strictly inserted pedicle screws according to the results of measurement and evaluated the efficacy by postoperative CT scanning.       Results      The insertion points for C

3

and C

4

was 2 to 3 mm beside the centrum median plane and in the opposite of operated pedicle

and 6 to 7 mm from the upper end-plate of centrum plane. The insertion points for C

3

-C

7

were in the same side of operated pedicle

point for C

5

1 to 2 mm beside the centrum median plane and 7 to 7.5 mm from the upper end-plate of centrum plane. These parameters for C

6

and C

7

were 4 to 5 mm and 7.5 to 8.5 mm respectively. The screw insertion direction was outside inclined in cross-sectional plane

and cranially inclined in sagittal plane. The favorable outside inclined angles for C

3

or C

4

C

5

and C

6

or C

7

were 46  to 47

48 and 36  to 40  respectively. Cranially inclined angles for them were -11  to -7

0  and 8  to 13  respectively. The screw length could be chosen among 28

30 and 32 mm

with a diameter of 3.5 mm. Basing on the relative measurements

we finally inserted 144 screws. Postoperative CT scan showed that all screws had arrived lateral side via anterior insertion into pedicle inside

but there were 16 screws exposure from pedicle lateral cortex

and 3 screws perforating pedicle lateral cortex

which mostly occurred in C

3

and C

4

.       Conclusion      Lower cervical spine ant

erior pedicle screw fixation is feasible.