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Lateral mass screw fixation in children
Daniel Hedequist1, Mark Proctor, Timothy Hresko
1Department of Orthopedic Surgery, Children's Hospital Boston/Harvard Medical School, 300 Longwood Avenue, Hunnewell 2 Bldg., Boston, MA 02114 USA.
Insights
Posterior cervical screw fixation is safe and effective in children for various spinal conditions. This technique enhances fixation strength without causing neurological or vascular complications.
Area of Science:
- Orthopedic Surgery
- Pediatric Spine Surgery
Background:
- Posterior cervical screw fixation in pediatric patients is not well-documented.
- Limited data exists on the safety and feasibility of this surgical technique in children.
Purpose of the Study:
- To evaluate the safety and feasibility of posterior cervical screw fixation in a pediatric cohort.
- To assess screw placement accuracy and complication rates in children undergoing posterior cervical instrumentation.
Main Methods:
- Retrospective review of 36 children (mean age 10 years) undergoing posterior cervical screw fixation.
- Analysis of diagnoses including instability, deformity, trauma, tumor, and congenital abnormalities.
- Review of operative reports and postoperative CT scans for technical feasibility, screw position, and complications.
Main Results:
- Screw placement was technically feasible in all cases.
- Postoperative CT scans confirmed 141 screws were completely contained.
- No neurologic complications, vertebral artery injuries, or screw-related complications were reported.
Conclusions:
- Posterior cervical screw fixation is a safe and feasible option for pediatric spinal disorders.
- This technique significantly enhances fixation strength for spinal instrumentation and fusion in children.
Purpose:
The safety and feasibility of posterior screw fixation of the cervical spine in children has not been well documented in the orthopedic literature. We performed a retrospective review of our experience using posterior cervical screw fixation in children.
Methods:
The medical records and radiologic records of 36 children at a mean age of 10 years (range 3-16 years) were reviewed. Diagnoses included: ten instability, 11 deformity, seven trauma, five tumor, and three congenital abnormalities. Operative reports and postoperative computed tomography (CT) scans were reviewed to determine the technical feasibility of screw placement, any screw-related complications, and to assess for correct screw position. In this series, there were no neurologic complications, no vertebral artery injuries, and no screw-related complications.
Results:
Thirty patients (141 screws) had screws evaluated postoperatively and were shown to be completely contained on postoperative CT scans. There were no revisions due to screw failure or dislodgement. There were no vascular or neurologic complications.
Conclusions:
Posterior screw fixation in the pediatric population may be done safely and greatly enhances fixation strength for a variety of disorders requiring instrumentation and fusion.
