Pediatric dens anatomy and its implications for fracture treatment: an anatomical and radiological study

Štulík, J; Geri, Gábor; SALAVCOVÁ, L.; Barna, M; Fojtík, Petr; Naňka, Ondřej

doi:10.1007/s00586-020-06490-9

Cited by 5 publications

(4 citation statements)

References 24 publications

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“…In addition, Štulík et al . demonstrated that the average screw angles of patients aged 0–6, 7–12, and 13–18 years old were 62.71°, 63.66°, and 60.76°, respectively 32 . In our study, the mean screw angles calculated from the youth, juvenile, and adolescent groups were 67.8 ± 3.2°, 67.8 ± 4.7°, and 64.3 ± 3.9°, respectively.…”

Section: Discussionsupporting

confidence: 53%

“…In addition, Štulík et al found that the average screw lengths of patients aged 0-6, 7-12, and 13-18 years old were 23.15 mm, 31.49 mm, and 39.37 mm, respectively. 32 Our study also indicated that screw length was positively related to age, which demonstrated that screws with shorter lengths should be used in younger children to avoid piercing the cortical bone, while older children need longer screws for better fixation. Screw angle is another important parameter for anterior odontoid fixation.…”

Section: Screw Length and Screw Angle Are Important Factors That Affe...supporting

confidence: 60%

“…Screw lengths in Fernandes's study were slightly shorter than those in the present study, and the reason may be that the investigated populations were from different regions and the sample size between the two studies was different. In addition, Štulík et al found that the average screw lengths of patients aged 0–6, 7–12, and 13–18 years old were 23.15 mm, 31.49 mm, and 39.37 mm, respectively 32 . Our study also indicated that screw length was positively related to age, which demonstrated that screws with shorter lengths should be used in younger children to avoid piercing the cortical bone, while older children need longer screws for better fixation.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 53%

Section: Screw Length and Screw Angle Are Important Factors That Affe...supporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

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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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“…Conservative management is considered without marked displacement of odontoid process and is applicable to most of the cases [ 29 , 68 ]. Operative osteosynthesis of dens is achieved through various techniques, and the gradual posterior angulation of dens through aging and its transverse dimension should be considered with odontoid screw fixation technique [ 93 ].…”

Section: Pediatric Cervical Spine Traumamentioning

confidence: 99%

Pediatric Spine Trauma

Hyun

2022

J Korean Neurosurg Soc

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Pediatric spine has growth potential with incomplete ossification, and also unique biomechanics which have important implications for trauma patients. This article intends to review various aspects of pediatric spine trauma including epidemiology, anatomy and biomechanics, and clinically relevant details of each type of injury based on the location and mechanism of injury. With the appropriate but not superfluous treatment, pediatric spine trauma patients can have better chance of recovery. Therefore, as a spine surgeon, understanding the general concept for each injury subtype together with the debate and progress in the field is inevitable.

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Pediatric atlas anatomy and its implications for fracture treatment: an anatomical and radiological study

Salavcová,

Štulík,

Štulík

et al. 2024

Neurocirugía (English Edition)

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Pediatric dens anatomy and its implications for fracture treatment: an anatomical and radiological study

Cited by 5 publications

References 24 publications

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

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

Pediatric Spine Trauma

Pediatric atlas anatomy and its implications for fracture treatment: an anatomical and radiological study

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