European Spine Journal ( IF 2.8 ) Pub Date : 2022-09-04 , DOI: 10.1007/s00586-022-07374-w Sheng-Yu Fu 1, 2 , Huan Liu 3 , Zhao-Rui Wang 1, 2 , Bang Wang 1, 2 , Xing-Bin Li 1, 2 , Ai-Bing Huang 1, 2
Purpose
To identify the ideal entry point for pediatric C2 pedicle screw and to obtain parameters of it for the indication of pediatric atlantoaxial fusion arthrodesis.
Methods
The pediatric cervical CT images were reconstructed into the 3D digital models and the C2 vertebrae were separated. The location of ideal entry point and screw placement related linear and angular parameters were assessed on the 3D digital models.
Results
A total of 214 pedicles from 107 C2 digital models were analyzed. The average entry point for C2 was 3.80 ± 2.78 mm medial to the lateral notch (LN) and 2.57 ± 1.70 mm superior to the LN. The average pedicle diameter (PD) was 6.02 ± 1.31 mm, and the average pedicle screw length (PSL) was 25.63 ± 3.46 mm. Statistical differences were found between different sex for PD and PSL (P < 0.05). As patient age increases, using the most lateral and inferior edge of the lateral mass as a reference marker, the entry point tends to move medial and cephalad, when using the LN as a reference marker, the entry point tends to move medial and slightly caudad. Univariate linear regression analysis suggested that these linear parameters were associated with age (P < 0.01).
Conclusion
In this study, we found that the measurement results of C2 pedicle screw varied based on sex, laterality, and ages for children younger than 18 years. The entry point of the screws facilitating ideal trajectory tends to change in a linear way as a function of age. This information helps the surgeon to establish the specific anatomy related to C2 pedicle screw placement to facilitate fixation in the pediatric patients.
中文翻译:
儿童 C2 椎弓根螺钉置入的理想切入点和轨迹:3D 计算机断层扫描研究
目的
确定小儿 C2 椎弓根螺钉的理想切入点并获取其参数以用于小儿寰枢椎融合关节融合术的适应症。
方法
将儿科颈椎 CT 图像重建为 3D 数字模型,并分离 C2 椎骨。在 3D 数字模型上评估了理想进入点的位置和螺钉放置相关的线性和角度参数。
结果
共分析了来自 107 个 C2 数字模型的 214 个椎弓根。C2 的平均进入点为外侧切迹 (LN) 内侧 3.80 ± 2.78 mm 和高于 LN 的 2.57 ± 1.70 mm。平均椎弓根直径 (PD) 为 6.02 ± 1.31 mm,平均椎弓根螺钉长度 (PSL) 为 25.63 ± 3.46 mm。不同性别的 PD 和 PSL 差异有统计学意义(P < 0.05)。随着患者年龄的增加,以侧块的最外侧和下缘为参考标记,进入点倾向于向内侧和头侧移动,当使用LN作为参考标记时,进入点倾向于向内侧和轻微尾侧移动. 单变量线性回归分析表明,这些线性参数与年龄相关(P < 0.01)。
结论
在这项研究中,我们发现对于 18 岁以下的儿童,C2 椎弓根螺钉的测量结果因性别、偏侧和年龄而异。促进理想轨迹的螺钉的进入点倾向于作为年龄的函数以线性方式变化。此信息有助于外科医生确定与 C2 椎弓根螺钉置入相关的特定解剖结构,以促进儿科患者的固定。