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C2 Translaminar Screw Fixation in Children.

Brian W Yang1,2, Michael P Glotzbecker1,2, Michael Troy2

  • 1Harvard Medical School.

Journal of Pediatric Orthopedics
|April 18, 2018
PubMed
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Translaminar C2 screw fixation is a safe and effective technique for pediatric cervical spine stabilization. This study found no screw-related complications or neurological injuries in children undergoing this procedure.

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Area of Science:

  • Orthopedic Surgery
  • Pediatric Spine Surgery
  • Spinal Instrumentation

Background:

  • Axis (C2) screw fixation is established for cervical stabilization in adults.
  • Translaminar C2 screw fixation efficacy in pediatric populations requires further investigation.
  • This study evaluates the application of translaminar C2 screw fixation in children.

Purpose of the Study:

  • To describe the indications for translaminar C2 screw fixation in pediatric cervical spine disorders.
  • To detail the surgical technique employed.
  • To report the clinical outcomes and complications in a pediatric case series.

Main Methods:

  • A retrospective review of a pediatric orthopedic database (2007-2017) identified patients undergoing C2 fusion.
  • Operative records were analyzed to confirm C2 translaminar screw placement.
  • Clinical data and pre/postoperative CT scans were assessed for diagnoses, complications, and outcomes.

Main Results:

  • 39 translaminar C2 screws were placed in 23 pediatric patients (mean age 12.6 years).
  • Indications included skeletal dysplasia, os odontoideum, congenital deformities, basilar invagination, tumors, and fractures.
  • No screw-related intraoperative or postoperative complications, or neurological injuries occurred; all patients achieved clinical union.

Conclusions:

  • Translaminar C2 screw fixation is a reliable surgical option for the pediatric population.
  • The technique demonstrated a favorable safety profile with no reported complications in this series.
  • Successful clinical union was achieved in all pediatric patients treated with translaminar C2 screws.