• Anterior transpedicular screw fixation of the subaxial cervical spine is anatomically feasible, with entry points and trajectories varying by vertebral level.
• Entry point locations and angles showed no significant differences between genders or sides, supporting standardized approaches.
• For most patients, screws of at least 30 mm length and 4.0 mm diameter (males) and 28 mm length and 3.5 mm diameter (females) are safe and reliable.
• Individualized preoperative planning using 3D CT reconstruction is essential to ensure accurate screw placement and avoid complications.