Artículos de revistas
Feasibility of Intralaminar, Lateral Mass, or Pedicle Axis Vertebra Screws in Children Under 10 Years of Age: A Tomographic Study
Fecha
2012Registro en:
NEUROSURGERY, PHILADELPHIA, v. 70, n. 4, supl. 2, Part 1-2, pp. 835-838, APR, 2012
0148-396X
10.1227/NEU.0b013e3182367417
Autor
Cristante, Alexandre Fogaca
Torelli, Alessandro Gonzalez
Kohlmann, Rafael Bellucci
da Rocha, Ivan Dias
Biraghi, Olavo Letaif
Iutaka, Alexandre Sadao
Marcon, Raphael Martus
Oliveira, Reginaldo Perilo
Pessoa de Barros Filho, Tarcisio Eloy
Institución
Resumen
BACKGROUND: There are several techniques for screw insertion in upper cervical spine surgery, and the use of the 3.5-mm screw is usually the standard. However, there is no consensus regarding the feasibility of using these screws in the pediatric population. OBJECTIVE: To determine the measurement of the lamina angle, lamina and pedicle length and thickness, and lateral mass length of the topographic axial view of the axis vertebra of 2- to 10-year-old children to guide the use of surgical screws. METHODS: Seventy-five computed tomography scans from 24- to 120-month-old patients were studied. Measurements were taken in an axial view of C2 and correlated with 2 age groups and both sexes. Statistical analysis was performed with the Student t test. RESULTS: In the 24- to 48-month age group, only 5.5% of the lamina and 8.3% of the pedicles had thicknesses < 3.5 mm. In the 49- to 120-month age group, there were no lamina thickness values < 3.5 mm, and 1.2% of pedicle thicknesses were < 3.5 mm. Both age groups had no lamina and pedicle lengths < 12 mm and no lateral mass lengths > 12 mm. CONCLUSION: In the majority of cases, the use of 3.5-mm lamina and pedicle screws in children is feasible. A base value of 45 degrees for the spinolaminar angle can be adopted as a reference for insertion of screws in the C2 lamina. This information can be particularly useful for decision making during preoperative planning for C1-C2 or craniocervical arthrodesis in children.