Journal of Korean Neurosurgical Society

  • 제56권6호
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  • Pages.475-481
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  • 2014
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Anatomic Feasibility of Posterior Cervical Pedicle Screw Placement in Children : Computerized Tomographic Analysis of Children Under 10 Years Old

  • Lee, HoJin (Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea) ;
  • Hong, Jae Taek (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea) ;
  • Kim, Il Sup (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea) ;
  • Kim, Moon Suk (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea) ;
  • Sung, Jae Hoon (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea) ;
  • Lee, Sang Won (Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea)
  • 투고 : 2014.04.24
  • 심사 : 2014.07.23
  • 발행 : 2014.12.28
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초록

Objective : To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement. Methods : A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011. Results : For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7). Conclusion : C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 translamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.

키워드

참고문헌

  1. Abumi K, Itoh H, Taneichi H, Kaneda K : Transpedicular screw fixation for traumatic lesions of the middle and lower cervical spine : description of the techniques and preliminary report. J Spinal Disord 7 : 19-28, 1994 https://doi.org/10.1097/00002517-199407010-00003
  2. Anderson RC, Ragel BT, Mocco J, Bohman LE, Brockmeyer DL : Selection of a rigid internal fixation construct for stabilization at the craniovertebral junction in pediatric patients. J Neurosurg 107 (1 Suppl) : 36-42, 2007
  3. Chamoun RB, Relyea KM, Johnson KK, Whitehead WE, Curry DJ, Luerssen TG, et al. : Use of axial and subaxial translaminar screw fixation in the management of upper cervical spinal instability in a series of 7 children. Neurosurgery 64 : 734-739; discussion 739, 2009 https://doi.org/10.1227/01.NEU.0000338950.46195.9C
  4. Chamoun RB, Whitehead WE, Curry DJ, Luerssen TG, Jea A : Computed tomography morphometric analysis for C-1 lateral mass screw placement in children. Clinical article. J Neurosurg Pediatr 3 : 20-23, 2009 https://doi.org/10.3171/2008.10.PEDS08224
  5. Chern JJ, Chamoun RB, Whitehead WE, Curry DJ, Luerssen TG, Jea A : Computed tomography morphometric analysis for axial and subaxial translaminar screw placement in the pediatric cervical spine. J Neurosurg Pediatr 3 : 121-128, 2009 https://doi.org/10.3171/2008.11.PEDS08277
  6. Cristante AF, Torelli AG, Kohlmann RB, Dias da Rocha I, Biraghi OL, Iu-taka AS, et al. : Feasibility of intralaminar, lateral mass, or pedicle axis vertebra screws in children under 10 years of age : a tomographic study. Neurosurgery 70 : 835-838; discussion 838-839, 2012 https://doi.org/10.1227/NEU.0b013e3182367417
  7. Ferri-de-Barros F, Little DG, Bridge C, Cummine J, Cree AK : Atlantoaxial and craniocervical arthrodesis in children : a tomographic study comparing suitability of C2 pedicles and C2 laminae for screw fixation. Spine (Phila Pa 1976) 35 : 291-293, 2010 https://doi.org/10.1097/BRS.0b013e3181afea7d
  8. Grob D, Crisco JJ 3rd, Panjabi MM, Wang P, Dvorak J : Biomechanical evaluation of four different posterior atlantoaxial fixation techniques. Spine (Phila Pa 1976) 17 : 480-490, 1992 https://doi.org/10.1097/00007632-199205000-00003
  9. Hedequist D, Proctor M, Hresko T : Lateral mass screw fixation in children. J Child Orthop 4 : 197-201, 2010 https://doi.org/10.1007/s11832-010-0251-0
  10. Hong JT, Sung JH, Son BC, Lee SW, Park CK : Significance of laminar screw fixation in the subaxial cervical spine. Spine (Phila Pa 1976) 33 : 1739-1743, 2008 https://doi.org/10.1097/BRS.0b013e31817d2aa2
  11. Hong JT, Yi JS, Kim JT, Ji C, Ryu KS, Park CK : Clinical and radiologic outcome of laminar screw at C2 and C7 for posterior instrumentation-- review of 25 cases and comparison of C2 and C7 intralaminar screw fixation. World Neurosurg 73 : 112-118; discussion e15, 2010 https://doi.org/10.1016/j.surneu.2009.06.010
  12. Hwang SW, Gressot LV, Rangel-Castilla L, Whitehead WE, Curry DJ, Bollo RJ, et al. : Outcomes of instrumented fusion in the pediatric cervical spine. J Neurosurg Spine 17 : 397-409, 2012 https://doi.org/10.3171/2012.8.SPINE12770
  13. Jea A, Johnson KK, Whitehead WE, Luerssen TG : Translaminar screw fixation in the subaxial pediatric cervical spine. J Neurosurg Pediatr 2 : 386-390, 2008 https://doi.org/10.3171/PED.2008.2.12.386
  14. Jea A, Taylor MD, Dirks PB, Kulkarni AV, Rutka JT, Drake JM : Incorporation of C-1 lateral mass screws in occipitocervical and atlantoaxial fusions for children 8 years of age or younger. Technical note. J Neurosurg 107 (2 Suppl) : 178-183, 2007 https://doi.org/10.3171/JNS-07/07/0178
  15. Jones EL, Heller JG, Silcox DH, Hutton WC : Cervical pedicle screws versus lateral mass screws. Anatomic feasibility and biomechanical comparison. Spine (Phila Pa 1976) 22 : 977-982, 1997 https://doi.org/10.1097/00007632-199705010-00009
  16. Kanna PR, Shetty AP, Rajasekaran S : Anatomical feasibility of pediatric cervical pedicle screw insertion by computed tomographic morphometric evaluation of 376 pediatric cervical pedicles. Spine (Phila Pa 1976) 36 : 1297-1304, 2011 https://doi.org/10.1097/BRS.0b013e3181fb3c17
  17. Leonard JR, Wright NM : Pediatric atlantoaxial fixation with bilateral, crossing C-2 translaminar screws. Technical note. J Neurosurg 104 (1 Suppl) : 59-63, 2006
  18. Mandel IM, Kambach BJ, Petersilge CA, Johnstone B, Yoo JU : Morphologic considerations of C2 isthmus dimensions for the placement of transarticular screws. Spine (Phila Pa 1976) 25 : 1542-1547, 2000 https://doi.org/10.1097/00007632-200006150-00014
  19. Melcher RP, Puttlitz CM, Kleinstueck FS, Lotz JC, Harms J, Bradford DS : Biomechanical testing of posterior atlantoaxial fixation techniques. Spine (Phila Pa 1976) 27 : 2435-2440, 2002 https://doi.org/10.1097/00007632-200211150-00004
  20. Meng XZ, Xu JX : The options of C2 fixation for os odontoideum : a radiographic study for the C2 pedicle and lamina anatomy. Eur Spine J 20 : 1921-1927, 2011 https://doi.org/10.1007/s00586-011-1893-4
  21. Oda I, Abumi K, Sell LC, Haggerty CJ, Cunningham BW, McAfee PC : Biomechanical evaluation of five different occipito-atlanto-axial fixation techniques. Spine (Phila Pa 1976) 24 : 2377-2382, 1999 https://doi.org/10.1097/00007632-199911150-00015
  22. Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K : Cervical human vertebrae. Quantitative three-dimensional anatomy of the middle and lower regions. Spine (Phila Pa 1976) 16 : 861-869, 1991 https://doi.org/10.1097/00007632-199108000-00001
  23. Rajasekaran S, Kanna PR, Shetty AP : Safety of cervical pedicle screw insertion in children : a clinicoradiological evaluation of computer-assisted insertion of 51 cervical pedicle screws including 28 subaxial pedicle screws in 16 children. Spine (Phila Pa 1976) 37 : E216-E223, 2012 https://doi.org/10.1097/BRS.0b013e318231bb81
  24. Sekhon LH : Posterior cervical lateral mass screw fixation : analysis of 1026 consecutive screws in 143 patients. J Spinal Disord Tech 18 : 297-303, 2005 https://doi.org/10.1097/01.bsd.0000166640.23448.09
  25. Vara CS, Thompson GH : A cadaveric examination of pediatric cervical pedicle morphology. Spine (Phila Pa 1976) 31 : 1107-1112, 2006 https://doi.org/10.1097/01.brs.0000216591.47505.17

피인용 문헌

  1. Guideline for C1 Lateral Mass and C2 Pedicle Screw Choices in Children Younger Than 6 Years vol.42, pp.16, 2014, https://doi.org/10.1097/brs.0000000000002016
  2. TOMOGRAPHIC ANALYSIS OF SUBAXIAL CERVICAL VERTEBRAE IN CHILDREN BETWEEN 0 AND 12 YEARS vol.16, pp.1, 2014, https://doi.org/10.1590/s1808-185120171601163228
  3. Anatomical considerations of C2 lamina for the placement of translaminar screw: a review of the literature vol.28, pp.3, 2014, https://doi.org/10.1007/s00590-017-2072-z
  4. An anatomical study of the spinous process of the seventh cervical vertebrae based on the three-dimensional computed tomography reconstruction vol.16, pp.2, 2014, https://doi.org/10.3892/etm.2018.6245
  5. Pediatric Spine Trauma: A Brief Review vol.87, pp.1, 2014, https://doi.org/10.1093/neuros/nyaa119
  6. Safety and Feasibility of Cervical Pedicle Screw Insertion in Pediatric Subaxial Cervical Spine Without Navigation: A Retrospective Cohort Study vol.41, pp.2, 2021, https://doi.org/10.1097/bpo.0000000000001694