Figure 24 C2 pedicle screws C2 pedicle screws. The pedicles of the C2 vertebra are directed toward the midline and in the cephalad inclination. Pedicle screws in this area impose a technical risk of injury to the vertebral artery laterally, the brain stem and dura medially, C2 nerve root in a cephalad direction and C3 nerve root in a caudal direction. Inferiorly the carotid artery is at risk for injury. Level: Structures: Other Structures: Pathology: Procedure: View: C1 – C2 Neural: Brainstem and spinal cord Dura Vascular: Carotid artery and vertebral arteries None Normal Position of C2 pedicle screws Composite (3/4), Front, Lateral, Caudal