The safety of spinal pedicle screws in children ages 1 to 12

Surgical treatment of adolescent idiopathic scoliosis in the United States from 1997 to 2012: an analysis of 20, 346 patients

“…These rises in charges may be caused, at least in part, by the increased use of advanced technology such as dense pedicle screw constructs, surgical navigation, and recombinant human bone morphogenetic protein utilization. 1,13,16,17,20 The trend toward posterior-based surgical techniques may be attributed to a number of different factors, including a perception of fewer complications 2,5 and decreased LOS 9 associated with segmental posterior instrumentation procedures. Furthermore, ongoing advances in posterior instrumentation technology have increased the ability to correct severe deformity through posterior techniques with 3-column osteotomies such as vertebral column resection.…”

“…12,28 In recent years, instrumented posterior fusion has been performed with greater regularity for the treatment of AIS. 1,14,16,17,[20][21][22] The relative proportion of anterior versus posterior procedures for patients with AIS was previously investigated by Martin et al, 18 who described the rising use of posterior-based techniques as well as the increasing charges associated with inpatient surgical care, although they did not report comorbidity or complication data.…”

At What Levels Are Freehand Pedicle Screws More Frequently Malpositioned in Children?

“…Patients in the coronal deformity group were younger and had longer fusions. The rate of screw malposition and associated complications in younger children, however, have not been reported to be higher compared with rates in older children [4,23,24].…”

“…Fifty-one screws in 16 patients were placed using fluoroscopy or intraoperative CT-guided navigation. These were excluded from the study, leaving 2,407 screws in 317 patients with diagnoses of adolescent idiopathic scoliosis (111), trauma (45), syndromic scoliosis (33), tumor (28), spondylolisthesis (24), neuromuscular disease (23), congenital scoliosis (22), juvenile idiopathic scoliosis (14), myelomeningocele (11), kyphosis (5), infection (1). Because of concerns regarding radiation exposure, postoperative CT scans are not routinely performed at our center.…”

Fracturas torácicas y lumbares en los adolescentes. Estudio de ocho años

“…La inestabilidad se presenta cuando existe una fractura con cifosis progresiva de más de 20°, pérdida de altura del cuerpo vertebral dañado de más del 50% y fragmentos en el canal vertebral, asociado a déficit neurológico [16][17][18] . La estabilización quirúrgica de la fractura dentro de las primeras 24 horas reduce las complicaciones relacionadas con el reposo 19 , y la utilización de tornillos pediculares ha mostrado ser más efectiva como método de fijación espinal tanto en los niños como en los adultos 20 . La región torácica (T2-T10) representa el sitio de mayor afección en los niños 21 .…”