In the majority of cases, the use of 3.5-mm lamina and pedicle screws in children is feasible. A base value of 45° 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.
ObjectiveTo carry out an anatomical study of the axis with the use of computed
tomography (CT) in children aged from two to ten years, measuring the lamina
angle, lamina and pedicle length and thickness, and lateral mass length.MethodsSixty-four CTs were studied from patients aged 24 to 120 months old, of both
sexes and without any cervical anomaly. The measurements obtained were
correlated with the data on age and sex of the patients. Statistical
analysis was performed using the Students "t" tests.ResultsWe found that within the age range 24-48 months, 5.5% of the lamina and 8.3%
of the pedicles had thicknesses of less than 3.5mm, which is the minimum
thickness needed for insertion of the screw. Between 49 and 120 months,
there were no lamina thicknesses of less than 3.5mm, and 1.2% of the pedicle
thicknesses were less than 3.5mm values. Neither of the age groups had any
lamina and pedicle lengths of less than 12mm, or lateral mass lengths
greater than 12mm.ConclusionThe analysis of the data obtained demonstrates that most of the time, is
possible to use a 3.5mm pedicle screw in the laminas and pedicles of the
axis in children. Level of Evidence: II, Development of
diagnostic criteria in consecutive patients.
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