title: Computed tomography morphometric analysis of C2 translaminar screw fixation of Wright's technique and a modified technique in the pediatric cervical spine.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou, 325027, China.
authors: Dong-Dong
authors: DD
authors: Xia
authors: Sheng-Lei
authors: SL
authors: Lin
authors: Wei
authors: W
authors: Chen
authors: Zhong-Hai
authors: ZH
authors: Shen
authors: Yao
authors: Y
authors: Li
authors: Xiang-Yang
authors: XY
authors: Wang
authors: Hua-Zi
authors: HZ
authors: Xu
authors: Yong-Long
authors: YL
authors: Chi
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D013123:Spinal Fusion / Q000379:methods*; D014057:Tomography, X-Ray Computed