• Junhao Liu, Wei Ji, Zucheng Huang, Ganggang Kong, Qi Liu, Zhiping Huang, Xiuhua Wu, and Qingan Zhu.
• Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
• Spine. 2018 Dec 15; 43 (24): E1437-E1442.

Study DesignRetrospective analysis of computed tomographic images of 92 normal pediatric cervical vertebrae.ObjectiveThe aim of this study was to ascertain the feasibility of the pedicle, intralaminar, and lateral mass screws fixation in children.Summary Of Background DataFixation techniques of C7 vertebrae are technically challenging in the pediatric population. Although the techniques offer alternatives to screws placement at C7 spine in adult, there is no consensus to apply these screws in children.MethodsA total of 92 patients (59 males and 33 females) from 3- to 16-year old divided into three groups (group 1, 1-6 years; group2, 7-10 years; group 3, 11-16 years) were included. Measurements were taken through computed tomography (CT) imaging without evidence of spinal trauma. Length, width, and angle of lamina and pedicle were measured, and lateral mass length was also assessed.ResultsThere was no statistical difference between the left and right sides, as well as the sexes. In 1 to 6 years' age group, 83.3% of the laminas and 87.5% of the pedicles measured have thicknesses of >3.5 mm. In 7 to 10 years' age group, 84.0% of the laminas and all the pedicles observed have thicknesses of >3.5 mm. In 11 to 16 years' age group, 88.4% of the laminas and 97.7% of the pedicles measured have thicknesses of >3.5 mm. Most of the spinolaminar angles were between 42.5° and 56°. There are three cases (3.3%) having lateral mass length >12 mm.ConclusionIt is feasible to insert a screw (Ø 3.5 mm) in C7 lamina in children, and the intralaminar screw fixation is a safe and reliable technique. Around 49°, the spinolaminar angle with axial position, can be used as reference for placing screws in the C7 lamina. Preoperative CT scan will help surgeons to insert the laminar screw safely and accurately.Level Of EvidenceN/A.

14 keywords...

hide…