Feasibility of anterior screw fixation in children: a tomographic study
Morphology measures of the odontoid process in children under 12 years old were carried out to demonstrate the viability of anterior internal fixation in this population once their active profile may not be compatible with successful conservative treatment.
During a 6-month period, 36 tomographic examinations of the cervical spine region that provided visualization of the odontoid process were selected. Group 1 included children between 6 and 9 years of age, and group 2 contained children from 9 to 12 years of age. There were 23 (63.8%) male patients and 13 (36.2%) female patients. Patients diagnosed with a tumor, an infection, fracture non-union, or congenital malformation were excluded. Exams were ordered as part of a protocol applied to non-specific neck pain and pediatric trauma entries. The following parameters were analyzed: (1) screw attack angle, (2) height of the odontoid process, and (3) minimal transverse diameter of the odontoid process.
In Groups 1 and 2, the average values of the screw attack angle were 55.9° ± 2.3° and 54.8° ± 4.5°, respectively; the average heights of the odontoid process were 26.58 ± 3.28 and 29.48 ± 3 mm, respectively, and the average minimal transverse diameter of the odontoid process were 6.57 ± 1.08 and 6.23 ± 0.88 mm, respectively. The minimal transverse diameter of the odontoid process was statistically higher in males than that in females, regardless of age (p = 0.007).
In both groups, the minimal transverse diameter of the odontoid process allowed for the use of one 3.5–4.5 mm screw for anterior internal fixation.
KeywordsOdontoid process Axis Computed tomography Internal fixation Children
All authors participated in the writing and review of the manuscript.
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Conflict of interest
The authors have no conflicts of interest to declare.
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