Cabrera Gabriela Estefanía Delgado, Fonseca Marcelo Giacomin DA, Tavares Mauro Costa Morais, Marcon Raphael Martus, Cristante Alexandre Fogaça, Letaif Olavo Biraghi
Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.
Acta Ortop Bras. 2021 May-Jun;29(3):153-158. doi: 10.1590/1413-785220212903238470.
To evaluate and compare anatomical measurements of C7, T1 and T2 vertebrae in children from 3 to 12 years of age to provide useful epidemiological data for determining the safe anatomical margin for transpedicular and translaminar fixation with screws in this population.
This observational retrospective cross-sectional study evaluated 76 computed tomography scans obtained over 6 months, analyzing the following parameters: the angle of attack, length, thickness and diameter of the pedicle; and the angle of attack, length and thickness of the lamina.
The lamina length and thickness, as well as pedicle length varied in size according to age. Although the angle of attack was similar across different ages, age-dependent variation occurred in the T1 vertebra.
Screws with a 3.5 mm diameter are safe to use in the C7 and T2 pedicles, while the T1 pedicle allows the introduction of larger screws ranging from 3.5-4.5 mm in diameter. In the lamina, 3.5 mm screws are safe for use only in children older than 7 years. However, each case should be analyzed individually, with the present study not aiming to replace the preoperative use of CT.
评估并比较3至12岁儿童C7、T1和T2椎体的解剖学测量数据,为确定该人群经椎弓根和经椎板螺钉固定的安全解剖边界提供有用的流行病学数据。
这项观察性回顾性横断面研究评估了6个月内获取的76份计算机断层扫描,分析了以下参数:椎弓根的入射角、长度、厚度和直径;以及椎板的入射角、长度和厚度。
椎板长度和厚度以及椎弓根长度随年龄而变化。尽管不同年龄的入射角相似,但T1椎体存在年龄依赖性变化。
直径3.5 mm的螺钉用于C7和T2椎弓根是安全的,而T1椎弓根可植入直径3.5 - 4.5 mm的较大螺钉。在椎板中,3.5 mm螺钉仅对7岁以上儿童使用安全。然而,每个病例都应单独分析,本研究并非旨在取代术前CT的使用。