Three-dimensional digitizing and anatomic study of lumbar vertebral canal and pedicle in children.

Abstract

IntroductionSpinal pedicle screw internal fixation has been widely used in adult spine injury fixation. Due to being in a period of continuous growth and development, the spine of children at different ages shows different characteristics from adults in terms of anatomy, physiological function, and biomechanics. Furthermore, because the pedicle of children is small, has large anatomic variation, and has complex adjacent relationships, the surgical risk is extremely high. How to improve the screwing accuracy is the key to the success of children’s pedicle internal fixation. Therefore, applying the concept of digitized and individualized screwing will be of great significance to children’s pedicle screwing.AimTo investigate the morphologies, development patterns, and aging characteristics of the lumbar vertebral pedicle (LVP) in children aged 6–11 years, and to provide a theoretical basis for screw implantation and related biomechanical studies.Material and methodsA total of 60 children aged 6–11 years were selected for the intergroup measurement and statistical analysis of their lumbar diameter, pedicle diameter, screw canal length (SCL), etc.ResultsGenerally, the vertebral foramen diameter (ID), sagittal diameter (SD), pedicle width (PW), and SCL as well as the pedicle height (PH) exhibited an increasing trend with age and increasing vertebral sequence among children aged 6–11 years.ConclusionsBy observing the LVP in children using 3D digital reconstruction technology, the morphology of the spinal canal and pedicles at different lumbar segments showed obvious development patterns, and the best treatment protocol should be selected according to the LVP characteristics in clinical applications.

The Impact of Cardiovascular Risk Factors on the Incidence, Severity, and Prognosis of Sudden Sensorineural Hearing Loss (SSHL): A Systematic Review

“…In addition, spinal cord manipulation has been suggested to induce SSHL, possibly through injury of vertebrobasilar vessels and interestingly, sympathetic ganglion block in the neck appears to be beneficial by improving inner ear circulation disturbances [23,33]. Finally, the blood supply of the cochlea depends on a single posterior terminal branch [34]. Genetically established susceptibility for thrombosis or risk factors for cardiovascular disease can cause microcirculation alteration in the inner ear [35].…”

Screw Pullout Strength After Pedicle Screw Reposition: A Finite Element Analysis

“…Although several studies considered the vertebrae to be linear materials in the FEA found that they are nonlinear materials in reality 37,38 . Another shortcoming of the study was the profile contour of the vertebrae, BMD, the dimensions of the pedicle, the thickness of the vertebral plate, and the length of the transverse process and spinous process were based on the high-resolution CT images of a single adult healthy woman, and might not be representative of the patient population 39,40 . Third, only the axial pullout was simulated, and the screw actually experienced loads in many directions, like bending loads up and down 13,41 .…”

“… 37 , 38 Another shortcoming of the study was the profile contour of the vertebrae, BMD, the dimensions of the pedicle, the thickness of the vertebral plate, and the length of the transverse process and spinous process were based on the high-resolution CT images of a single adult healthy woman, and might not be representative of the patient population. 39 , 40 Third, only the axial pullout was simulated, and the screw actually experienced loads in many directions, like bending loads up and down. 13 , 41 A last limitation of the study was that the results based on the FEA must be verified by in vitro experiments in the future to be truly convincing.…”

Comparison and Evaluation of the Accuracy for Thoracic and Lumbar Pedicle Screw Fixation in Early-Onset Congenital Scoliosis Children

“…In children, the spine is in a continuous growth stage, exhibiting distinct anatomical, physiological, and biomechanical characteristics [10]. Notably, the corresponding vertebral pedicles are relatively smaller in comparison to those of adults.…”