Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Spine (Phila Pa 1976). 2018 Dec 15;43(24):E1437-E1442. doi: 10.1097/BRS.0000000000002742.
Retrospective analysis of computed tomographic images of 92 normal pediatric cervical vertebrae.
The aim of this study was to ascertain the feasibility of the pedicle, intralaminar, and lateral mass screws fixation in children.
Fixation 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.
A 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.
There 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.
It 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.
N/A.
92 例正常儿童颈椎 CT 图像的回顾性分析。
本研究旨在确定儿童椎弓根、板内和侧块螺钉固定的可行性。
儿童 C7 椎体的固定技术具有挑战性。虽然这些技术为成人 C7 脊柱螺钉固定提供了替代方法，但尚无共识将这些螺钉应用于儿童。
共纳入 3 至 16 岁的 92 例患者（男 59 例，女 33 例），分为三组（第 1 组：1-6 岁；第 2 组：7-10 岁；第 3 组：11-16 岁）。测量均通过无脊柱外伤 CT 成像进行。测量了椎板的长度、宽度和角度以及侧块的长度。
左右两侧以及性别之间无统计学差异。在 1 至 6 岁年龄组，83.3%的椎板和 87.5%的椎弓根厚度>3.5mm。在 7 至 10 岁年龄组，84.0%的椎板和所有观察到的椎弓根厚度>3.5mm。在 11 至 16 岁年龄组，88.4%的椎板和 97.7%的椎弓根厚度>3.5mm。大多数椎板-棘突角在 42.5°至 56°之间。有 3 例（3.3%）侧块长度>12mm。
在儿童 C7 椎板中插入（Ø 3.5mm）螺钉是可行的，板内螺钉固定是一种安全可靠的技术。椎板-棘突角约 49°，与轴向位置一致，可作为 C7 椎板螺钉放置的参考。术前 CT 扫描将有助于外科医生安全准确地插入椎板螺钉。
N/A。
