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Eur Spine J. 2014 Mar;23(3):606-12. doi: 10.1007/s00586-013-3130-9. Epub 2013 Dec 12.

Computed tomography morphometric analysis of C2 translaminar screw fixation of Wright's technique and a modified technique in the pediatric cervical spine.

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  • 1Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China.

Abstract

PURPOSE:

To establish reference data on the dimensions of C2 lamina to guide the use of translaminar screws with Wright's technique and a modified technique for pediatric patients in different age groups.

METHODS:

113 pediatric patients were divided into six age groups, and their cervical vertebrae were studied on CT scans. Laminar height, width, length and screw angle were measured. Statistical analysis was performed using Student t tests, Pearson's correlation and linear regression analysis.

RESULTS:

Mean laminar height was 10.95 ± 2.81 mm, and mean width was 6.01 ± 0.90 mm. For Wright's technique, mean laminar length was 30.65 ± 3 mm, and the screw angle was 56.02° ± 3.62°. For the modified technique, mean laminar length was 22.07 ± 2.38 mm, and the screw angle was 67.40° ± 3.39°. 95.6% (108/113) of the children could insert a screw into the lamina (laminar width ≥ 4.5 mm), 72.6% (82/113) could accept bilateral translaminar screws (laminar width ≥ 4.5 mm and laminar height ≥ 9 mm).

CONCLUSION:

Our investigation provides insight into the anatomy of C2 lamina in six pediatric age groups. Compared to adults, the benefits of C2 translaminar screws fixation are more obvious in the pediatric spine which has a large C2 lamina. Compared to Wright's technique, the modified technique should insert a screw with bigger insert angle and shorter screw length.

PMID:
24337233
PMCID:
PMC3940813
DOI:
10.1007/s00586-013-3130-9
[PubMed - indexed for MEDLINE]
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