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Pediatric cervical spine instrumentation using screw fixation

D Brockmeyer1, R Apfelbaum, R Tippets

  • 1Department of Neurosurgery, University of Utah Medical Center, Salt Lake City, USA.

Pediatric Neurosurgery
|January 1, 1995
PubMed
Summary
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Pediatric cervical spine screw fixation is safe and effective for stabilizing young patients. These procedures demonstrated no long-term failures and improved neurological status in some cases.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Neurosurgery
  • Spinal Instrumentation

Background:

  • Pediatric cervical spine instability presents unique challenges.
  • Surgical stabilization is crucial for preventing neurological deficits.
  • Advancements in instrumentation are vital for pediatric spinal surgery.

Observation:

  • 24 cervical spine screw fixation procedures were performed on 23 patients (≤16 years old) between 1986 and 1993.
  • Indications included traumatic instability (20 cases), congenital instability (1 case), and complex cases with prior failed fusions (6 patients).
  • Procedures included anterior cervical plates, posterior C1-2 screw fixations, posterior lateral mass plates, and odontoid screw fixations.

Findings:

  • Eight patients experienced improved neurological status post-operation; 15 maintained their preoperative level.

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  • No patients had worsened neurological function.
  • No long-term instrumentation, graft, or fusion failures were observed.
  • Two complications occurred: one graft/hardware failure requiring reoperation and one superficial wound infection.

    • Implications:

    • Cervical spine fixation techniques enhance the ability to stabilize the pediatric cervical spine.
    • These methods are proven safe and effective for pediatric patients.
    • Further research into long-term outcomes of pediatric cervical spine instrumentation is warranted.