Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation

Menger, Richard; Storey, Christopher; Nixon, Menarvia; Haydel, Justin; Nanda, Anil; Sin, Anthony

doi:10.14444/2043

Cited by 9 publications

(3 citation statements)

References 23 publications

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“…The pedicle screw internal fixation technology, characterised by its stable and firm biomechanical features, is widely used in treating cervical vertebral injuries in adults [9,10,20]. Ruf and Harms [15] performed the hemivertebral resection plus pedicle screw internal fixation in 28 paediatric patients with congenital scoliosis (1-6 years old) and achieved satisfactory results.…”

Section: Discussionmentioning

confidence: 99%

Applications of digital technology for the morphological study of C3–C7 vertebral arch pedicle in children

Zhang

Wang

Ren³

et al. 2017

Folia Morphol

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Section: Discussionmentioning

confidence: 99%

Applications of digital technology for the morphological study of C3–C7 vertebral arch pedicle in children

Zhang

Wang

Ren³

et al. 2017

Folia Morphol

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“…[ 11 12 ] Lateral mass, pedicle/pars interarticularis, and laminar screws were placed at C1 and C2. After confirmation of an adequate pb-C2 and CXA measurements using intraoperative computed tomography,[ 13 14 15 16 ] the rods were locked to the screws and morcellated local autograft and allograft were put in place. Figures 1 and 2 show patients with CCF using either OB anchors or OC screws.…”

Section: Methodsmentioning

confidence: 99%

Ehlers–Danlos syndrome-associated craniocervical instability with cervicomedullary syndrome: Comparing outcome of craniocervical fusion with occipital bone versus occipital condyle fixation

Spiessberger

Dietz

Grüter

et al. 2020

J Craniovert Jun Spine

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Introduction: Ehlers–Danlos syndrome (EDS) predisposes to craniocervical instability (CCI) with resulting cranial settling and cervicomedullary syndrome due to ligamentous laxity. This study investigates possible differences in radiographic outcomes and operative complication rate between two surgical techniques in patients with EDS and CCI undergoing craniocervical fusion (CCF): occipital bone (OB) versus occipital condyle (OC) fixation. Methods: A retrospective search of the institutional operative database between January 07, 2017, and December 31, 2019, was conducted to identify EDS patients who underwent CCF with either OB (Group OB) or OC (Group OC) fixation. For each patient, pre- and post-operative radiographic measurements and operative complications were extracted and compared between groups (OB vs. OC): pB-C2, clivoaxial angle (CXA), tonsillar descent, C2C7 sagittal Cobb angle, C2 long axis, and operative complications. Results: Of a total of 26 patients, 13 underwent OV and 13 underwent OC fixation. Eighty-five percent of the patients underwent OC underwent fusion from occiput to C2, while the remaining 15% fusion from occiput to C3. Radiographic outcome in the OC versus OB group was preoperative measurements were similar between OC and OB group: pB-C2 8.8 mm (1.5, 6–11) versus 8.3 mm (1.7, 4–9.6), P = 0.43; CXA 128.2° (5.4, 122–136) versus 131.9° (6.8,122–141), P = 0.41; tonsillar descent 6.2 mm (4.8, 0–15) versus 2.9 mm (3.4, 0–8), P = 0.05; C2 long axis 75.2° (6.7, 58–85) versus 67.2° (21.4, 1–80), P = 0.21; postoperative change of CXA + 14.4° (8.8, 0–30) versus 16.2° (12.4, −4–38), P = 0.43; change of pB-C2 − 2.6 mm (1.8, −-5.3 to 0) versus − 1.2 mm (4, −4.6–8), P = 0.26; and postoperative C2C7 sagittal Cobb angle − 2.6° (19.5, −43–39) versus − 2.6° (11.4, −21–12). Operative complications were seen in 1 out of 13 patients (8%) versus 2 out of 13 patients (16%), P = 1. Conclusions: In EDS, patients with CCI undergoing CCF radiographic and clinical outcome were similar between those with OC versus OB fixation. Both techniques resulted in sufficient correction of pB-C2 and CXA measurements with a low complication rate.

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“…With advances in science, pedicle screw fixation technology has developed into a mature spinal surgical technique for treating adolescents and adults with spinal trauma, infectious lesions, degenerative lesions, or neoplastic lesions, and it particularly plays a crucial role in orthopedic surgery for spinal deformity [ 1 – 3 ]. The pedicle system could effectively restore the spinal physiological curvature in the treatment of thoracolumbar spine fractures and vertebral fractures and could also achieve good reduction via distraction, thus achieving the purpose of 3D fixation.…”

Section: Introductionmentioning

confidence: 99%

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

Wang¹,

Zhang

et al. 2018

Videosurgery and Other Miniinvasive Techniques

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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.

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Placement of C1 Pedicle Screws Using Minimal Exposure: Radiographic, Clinical, and Literature Validation

Cited by 9 publications

References 23 publications

Applications of digital technology for the morphological study of C3–C7 vertebral arch pedicle in children

Applications of digital technology for the morphological study of C3–C7 vertebral arch pedicle in children

Ehlers–Danlos syndrome-associated craniocervical instability with cervicomedullary syndrome: Comparing outcome of craniocervical fusion with occipital bone versus occipital condyle fixation

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

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