An anatomic study on feasibility of pedicle screw or laminar screw implant in the axis of children

WANG Jianhua; XIA Hong; YIN Qingshui; WU You; ZHU Changrong; QIAO Guoqing

doi:10.3969/j.issn.1674-666X.2013.06.002

Abstract：Objective To investigate the feasibility for internal fixation of pedicle screw and laminar screw in the axis of children. Methods Thirty-two sets of cervical CT scan images of children (age range from 2 to 10 years old) treated in Guangzhou General Hospital of Guangzhou Military Command from 2009 to 2012 were slected, in which there were 16 sets (32 sides) in play age group (age range from 2 to 5 years old ) and other 16 sets (32 sides) in primary school-age group (age range from 5 to 10 years old). The axial pedicle width, length and introvert angle of pedicle screw trajectory, as well as the isthmus width of lamina, length and outward angle of laminar screw trajectory were measured by PACS tools respectively. Results There were 15 sides where pedicle width of pedicle screw trajectory > 3.5 mm in play age group and 26 sides in primary school-age group;while 24 sides where isthmus width of laminar screw trajectory > 3.5 mm in play age group and 31 sides in primary school-age group. Differences of average width, length of pedicle and larmina all showed statistical significance between 2 groups (P <0.05), as for introvert angle of pedicle screw trajectory and outward angle of laminar screw trajectory, there had no statistical differences between 2 groups (P >0.05). Conclusions It is mostly feasible for axis pedicle screw and laminar screw implant for primary school-age children. For the play age children, based on preoperative accurate measurement and evaluation of relative screw implant anatomic parameters through thin slice cervical CT scan images, laminar or pedicle screw or mixed internal fixation should be chosen reasonably so as to provide safe and efficient fixation.