Análise tomográfica dos parâmetros anatômicos do áxis de crianças

Torelli, Alessandro Gonzalez; Kohlmann, Rafael Bellucci; Biraghi, Olavo Letaif; Iutaka, Alexandre Sadao; Cristante, Alexandre Fogaça; Marcon, Raphael Martus

doi:10.1590/s1413-78522012000200003

Cited by 5 publications

(3 citation statements)

References 6 publications

(15 reference statements)

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“…On the one hand, we discovered through evaluation of the projected area of the SPC the maximum inner circle diameter of the SPC, with no significant difference compared with that for the GPC. The pedicle corridor with a diameter greater than 4 mm can generally accommodate a 3.5 mm screw,25,26 and 81.2% of patients can accommodate an SPC screw with a diameter of 3.5 mm in this study. Therefore, we consider that the safety of SPC screw placement is consistent with that of the GPC screw.…”

Section: Discussionmentioning

confidence: 76%

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

Deng

Zeng

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Study Design: A 3D-CT Study. Objective: To research the feasibility and advantages of screw corridors parallel to the sagittal plane (SPC) of the C2 for transpedicular fixation. Summary of Background Data: A total of 125 patients were enrolled for analysis, and the 3D model of the C2 for the 125 patients were reconstructed and analyzed. Methods: The SPC screw and the corridor of the general pedicle (GPC) screw of both sides were inserted into these C2 models. The anatomic parameters of the SPC and GPC, including the inner circle diameter, length of the corridors, medial angle and cephalad angle, were measured and compared. The anatomic location of the entry point for the SPC screw was evaluated. Results: The diameter of the SPC averaged 5.5±1.8 mm; 81.2% (203/250) were larger than 4 mm. There was no significant difference between the SPC and GPC in diameter or percentage of diameter greater than 4 mm. There was a significant difference between the length of the SPC (25.3±2.4 mm) and the GPC (27.4±2.2 mm). The cephalad angle was 51.6±6.9° for the SPC and 43.3±4.4° for the GPC, and there was a significant difference between the SPC and GPC. The entry point of the SPC screw was located on the cortical crest at the lower 1/4 of the lamina and located to the lower and inner side of the GPC screw entry point. Conclusion: It is feasible for most patients to accommodate an SPC screw with a diameter of 3.5 mm. All SPC screws crossed the pedicle completely. The optimal entry point of the SPC screw was located on the cortical crest of the axial lamina.

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Section: Discussionmentioning

confidence: 76%

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

Deng

Zeng

et al. 2022

Clinical Spine Surgery: A Spine Publication

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“…[7][8][9][10] However, for unstable and displaced fractures, such as type II and rostral type III fractures, surgical intervention is required to increase the fusion rate and avoid serious consequences, such as medullary compression and dynamic instability. 11,12 Compared to traditional surgeries, anterior screw fixation can preserve the normal range of atlantoaxial motion and has excellent fusion rates. 13,14 Although some cases of odontoid fractures in patients under 18 years old have been treated by anterior screw fixation, 15,16 performing anterior screw fixation in children has been associated with screw loosening, screw penetration, screw migration, dysphagia, broken Kirschner wires, or even severe neurovascular damage.…”

Section: Introductionmentioning

confidence: 99%

“…Non‐operative treatments, such as traction, reduction, and external orthosis, are common management options for type I odontoid fractures and achieve a high fusion rate 7–10 . However, for unstable and displaced fractures, such as type II and rostral type III fractures, surgical intervention is required to increase the fusion rate and avoid serious consequences, such as medullary compression and dynamic instability 11,12 . Compared to traditional surgeries, anterior screw fixation can preserve the normal range of atlantoaxial motion and has excellent fusion rates 13,14 …”

Section: Introductionmentioning

confidence: 99%

Feasibility of Anterior Fixation with Single Screw for Odontoid Fractures in Pediatrics: A Computed Tomographic Study

Lin

Huang

et al. 2023

Orthopaedic Surgery

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ObjectiveAlthough it is an effective fixation technique for an unstable odontoid, anterior fixation remains challenging in pediatric populations. Our study measures the anatomical parameters of the odontoid to identify the feasibility of anterior fixation with a single screw for children.MethodsWe retrospectively collected data from 112 normal male and female children (aged between 2 and 18) in our institute from January 1, 2022 to December 31, 2022. Subjects were divided into a youth group (2–6 years old), a juvenile group (7–12 years old), and an adolescent group (13–18 years old). Sagittal and coronal computed tomography images of the upper cervical spine were used to measure the screw length, angle, and inner and outer diameters of the odontoid. One‐way analysis of variance with the Tukey test was used to analyze the parameters among the groups, while the t‐test was used to analyze gender differences. Correlations between parameters and age were assessed using Pearson's test.ResultsThere were significant differences between male and female subjects in screw length and inner and outer diameters (of both sagittal and coronal views) but not in screw angle. The narrowest diameter of the odontoid was 4.0 ± 1.5 mm in the youth group, 5.5 ± 1.5 mm in the juvenile group, and 5.6 ± 1.1 mm in the adolescent group, respectively. There were significant differences among the three groups in screw length (p < 0.0001). The screw angle of the adolescent group was significantly smaller than that of the youth and juvenile groups. More than 90% of children aged 7–18 years old had an odontoid diameter greater than 4 mm, while only half of the youth group had an odontoid with diameter >4 mm. Screw length and inner and outer diameters in lateral view were positively correlated with age, and screw angle was negatively correlated with age.ConclusionIt is feasible to insert a standard single screw (Φ 3.5 mm) into the odontoid of children aged 7–18 years old but not those aged 2–6 years old. How the anatomical parameters of the odontoid change with age, especially the narrowest diameters, is worthy of attention.

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Feasibility of 3.5 mm C2 pedicle screws in children: A computerized tomography analysis

Chen

Cen

et al. 2022

Clinical Anatomy

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There have been no studies with large sample sizes on growth of the pedicle of C2 in children. In the present study we measured the pedicle of C2 through computed tomography (CT) imaging in children aged less than 14 years and evaluated the suitability of the 3.5‐mm screw for the pedicle in such children. The study was conducted on CT morphometric images of 420 children in our hospital between June 2018 and June 2020. The width (D1), length (D2), height (D3), inclination angle (α), and tail angle (β) of the C2 pedicle were measured. One‐way analysis of variance and Student's t test were used for statistical analyses. The least‐square method was used to analyze the curve fitting the trend of anatomical change in the pedicle. The largest degree of goodness of fit determined the best‐fitting curve. The size of the pedicle of C2 increased with age. The median ranges of D1, D2, D3, α, and β were 3.312–5.431 mm, 11.732–23.645 mm, 3.597–8.038 mm, 32.583°–36.640°, and 24.867°–31.567°, respectively. The curves fitting the trends of D1 and D3 were power functions, whereas D2 was fitted by a logarithmic curve. However, no curve fitted α or β. A 3.5‐mm screw can be placed in the pedicle of C2 in children aged more than 1 year. The growth and development trend of this pedicle can provide an anatomical reference for deciding on posterior cervical surgery and for selecting and designing pedicle screws for children.

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Análise tomográfica dos parâmetros anatômicos do áxis de crianças

Cited by 5 publications

References 6 publications

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

A Novel C2 Screw Corridor Parallel to the Sagittal Plane for Transpedicular Fixation – A 3D-CT Study

Feasibility of Anterior Fixation with Single Screw for Odontoid Fractures in Pediatrics: A Computed Tomographic Study

Feasibility of 3.5 mm C2 pedicle screws in children: A computerized tomography analysis

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