The Effect of Pedicle Screw Placement With or Without Application of Compression Across the Neurocentral Cartilage on the Morphology of the Spinal Canal and Pedicle in Immature Pigs

Çil, Akın; Yazıcı, Muharrem; Dağlıoğlu, Kenan; Aydıngöz, Üstün; Alanay, Ahmet; Acaroğlu, Emre; Gulsen, Mahir; Surat, Adil

doi:10.1097/01.brs.0000164136.95885.e7

Cited by 68 publications

(64 citation statements)

References 21 publications

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“…In immature animals experiment, it has been shown that vertebral growth is retarded by inhibition of the NCC. The pedicle screws have an influence in development on symmetry and canal parameters [13][14][15]. The consistent findings of negative effects imparted upon pedicle growth in these previous animal studies have increased the concerns that pedicle screws used in young children might result in similar problems.…”

Section: Introductionmentioning

confidence: 48%

“…It allows a short fusion and the preservation of motion segments because of a rigid segmental stabilization. In spinal deformities surgery, segmental transpedicular instrumentation provides a superior correction of deformity in the coronal, sagittal, and transverse planes [13]. In pediatric scoliosis, there is no other chance to get a firm anchorage for correction and stabilization.…”

Section: Discussionmentioning

confidence: 99%

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X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years

et al. 2013

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Purpose To determine the reliability of pedicle screws placed in children younger than 7 years of age, and to evaluate the effect of pedicle screw insertion on further growth of the vertebra and spinal canal. Methods A retrospective study of 35 consecutive patients through Jan 2003-Dec 2010 for congenital scoliosis in \7 years children was performed at one spine center. Patients undergoing pedicle screw instrumentation of at least two levels, which had been followed-up for at least 24 months were included. Measurements were performed in instrumented and adjacent non-instrumented levels. The effect of pedicle screw insertion on further growth was evaluated. Results The average age at surgery was 4.4 year (53 months, range, 23-84 months). 190 segments in 35 patients met the inclusion criteria. 77 segments had no screws and 113 had at least one screw. There was a significant difference between the pre-operative and final follow-up values of the measurement of spinal canal and vertebral body parameters (P \ 0.001). No significant difference existed between growth rates of vertebral bodies and the sagittal diameters of spinal canal with or without screws. The growth rates of vertebral bodies in lumbar spine were higher than in thoracic spine in both instrumented and adjacent groups. Conclusion Pedicle screw instrumentation does not cause a retardation effect on the development of vertebral bodies and the spinal canal in children at an early age. It is a safe and reliable procedure to achieve a stable fixation.

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Section: Introductionmentioning

confidence: 48%

Section: Discussionmentioning

confidence: 99%

X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years

et al. 2013

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“…The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. (1) Pedicle diameters on the transverse plane decreased gradually from T1 to T4 and increased gradually from T5 to T12. The shortest transverse diameter of the thoracic pedicle was T4 or T5.…”

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confidence: 99%

Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine

Chen

Huang

et al. 2008

International Orthopaedics (SICOT)

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Our objective was to quantify the morphometric characteristics of the pedicles of the Chinese immature thoracic spine. A total of 120 patients aged 5-14 years underwent standard thoracic computed tomography (CT). The patients were grouped according to age: group 1 (5-8 years of age), group 2 (9-11 years of age) and group 3 (12-14 years of age). Images were reformatted, and multiplanar reconstructions were used to attain images of thoracic pedicles on sagittal, coronal and transverse planes. The measurements included the inner and outer pedicle diameters on the transverse plane, pedicle sagittal diameter, pedicle length and the pedicle angle on the transverse. (1) Pedicle diameters on the transverse plane decreased gradually from T1 to T4 and increased gradually from T5 to T12. The shortest transverse diameter of the thoracic pedicle was T4 or T5. (2) The sagittal diameter was significantly larger than the transverse diameter except at T1. (3) The length of the pedicle from the posterior cortex to the anterior cortex of the vertebra increased from T1 to T12. (4) The pedicle angle decreased gradually from T1 to T8 and became negative below the level of T10. The length of the pedicle changed with age significantly, but the pedicle angle changed with age insignificantly. The success of transpedicular fixation requires a better understanding of morphological features at different ages and reasonable selection of the diameter, length and direction of the pedicle screws based on X-ray and CT films.

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“…One previous study suggests injury to the NCS or application of compressive forces across the NCS results in iatrogenic spinal stenosis in an animal model [2]. Using a histomorphometric analysis in an 8-week-old pig model, Zhang and Sucato demonstrated unilateral pedicle NCS screws do not lead to narrowing of the total spinal canal area [18].…”

Section: Discussionmentioning

confidence: 99%

Neurocentral Synchondrosis Screws to Create and Correct Experimental Deformity: A Pilot Study

Zhao

Sucato

2011

Clinical Orthopaedics &Amp; Related Research

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Background Unilateral pedicle screw epiphysiodesis of the neurocentral synchondrosis (NCS) can produce asymmetric growth of the synchondrosis to create scoliosis in an immature animal model. Questions/purposes We asked whether a preexisting experimentally created scoliosis could be limited and corrected by modulating the growth of the faster-growing NCS by a similar method. Methods Nine 1-month-old pigs were assigned to each of three groups: (1) a sham group in which three animals received a sham operation but without a pedicle screw fixation; (2) an experimental group with double right pedicle screws placed across the NCS from T7 to T14 (scoliosis-untreated); and (3) an experimental group treated in the same way except a second set of double pedicle screws was placed in the left pedicles 6 weeks after the screws were placed on the right (scoliosis-treated). All animals were euthanized at 17 weeks, and radiographs and axial CT images of the spine were obtained. Results A scoliotic curve was not seen in any of the animals in the sham group, in three of three in the scoliosisuntreated group with an average of 34°, and in three of three in the scoliosis-treated group with an average of 20°. In comparison to the scoliosis-untreated group, the second set of pedicle screws produced a 41% correction of the scoliosis. Conclusions We found the pedicle screw inhibited the overgrowth of the NCS to prevent further curve progression and obtained some correction of the deformity. The NCS screw epiphysiodesis can create and reverse scoliosis in an immature pig model.

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The Effect of Pedicle Screw Placement With or Without Application of Compression Across the Neurocentral Cartilage on the Morphology of the Spinal Canal and Pedicle in Immature Pigs

Cited by 68 publications

References 21 publications

X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years

X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years

Computed tomographic morphometry of thoracic pedicles: safety pedicle parameter measurement of the Chinese immature thoracic spine

Neurocentral Synchondrosis Screws to Create and Correct Experimental Deformity: A Pilot Study

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