2022, Vol. 26 ›› Issue (9): 1383-1387

Feasibility of axial transpedicle screw internal fixation in children aged 1 to 6 years

Li Kun1, Gao Erke2, Xiong Feng3, Wang Xing1, 3, Wu Danqi2, Li Zhijun1, 3, Zhang Shaojie1, 3, Liu Yanan2, Duo Lan2, Li Ziyu2

1Department of Human Anatomy, 2Graduate School, 3Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China

Received:2021-05-22 Revised:2021-05-25 Accepted:2021-07-28 Online:2022-03-28 Published:2021-12-10
Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Human Anatomy, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Zhang Shaojie, Professor, Master’s supervisor, Department of Human Anatomy, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
About author:Li Kun, Master, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
Supported by:
National Natural Science Foundation of China, No. 81860382 (to WX); National Natural Science Foundation of China, No. 81860383 (to LZJ); National Natural Science Foundation of China, No. 81660358 (to ZSJ); Graduate Research in Inner Mongolia Autonomous Region Innovation Fund Project, No. S2018112010Z (to LK); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020LH08021 (to LZJ); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2019MS08017 (to ZSJ); Science and Technology Development Planned Project of Inner Mongolia Autonomous Region, No. 2019GG158 (to WX); Youth Innovation Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK); Talent Cultivation Project of Inner Mongolia Medical University, No. YCPY2021050 (to XF)

Abstract: BACKGROUND: Internal screw fixation is often required for the treatment of specific axial pedicle fractures in the occipito-atlanto-axial complex region and is widely used in adults. However, there are no anatomic data on the development of the axial pedicle with common internal fixation in children aged 1 to 6 years.
OBJECTIVE: To investigate the feasibility of 3.50 mm perpedicle screw internal fixation of axial vertebrae in children aged 1 to 6 years.
METHODS: Totally 45 children aged 1 to 6 years were selected and divided into three groups: 1-year-old group, 3-year-old group, 5-6-year-old group, with 15 cases in each group. The original cervical CT data were obtained. The width of the upper, middle and lower edges of the vertebral pedicle, the height and length of the vertebral pedicle, the inclination angle and the upclination angle of the screw were measured after three-dimensnioal reconstruction. In each case, the related index parameters of bilateral pedicle were measured, and each parameter index was measured three times, and the average value was taken.

RESULTS AND CONCLUSION: (1) All the indexes of axial pedicle showed an increasing trend with age, except the upper inclination and inner inclination. (2) The width of the upper edge of the vertebral pedicle, the width of the middle edge of the vertebral pedicle and the width of the lower edge of the vertebral pedicle were significantly different among the same age groups. (3) The main limiting factors of axial pedicle screw insertion and stability were the median edge width and length of the vertebral pedicle. The median edge width of the vertebral pedicle was (4.26±0.68) mm in 1-year-old group, (4.92±0.83) mm in 3-year-old group, and (6.26±1.26) mm in 5-6-year-old group. The pedicle length was (12.38±2.10) mm in 1-year-old group, (21.00±5.39) mm in 3-year-old group, and (24.62±1.11) mm in 5-6-year-old group. (4) These results confirm the feasibility of inserting 3.50 mm screws in the axial pedicle of children aged 1-6 years. The screw placement methods should be different in different age groups.

Key words:children, axial pedicle, digital measurement, screw internal fixation, spiral CT, anatomical shape

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