title: Anatomic feasibility of posterior cervical pedicle screw placement in children: computerized tomographic analysis of children under 10 years old.
abstract: OBJECTIVE
  To evaluate the anatomical feasibility of 3.5 mm screw into the cervical spine in the pediatric population and to establish useful guidelines for their placement.
  
  
  METHODS
  A total of 37 cervical spine computerized tomography scans (24 boys and 13 girls) were included in this study. All patients were younger than 10 years of age at the time of evaluation for the period of 2007-2011.
  
  
  RESULTS
  For the C1 screw placement, entry point height (EPH) was the most restrictive factor (47.3% patients were larger than 3.5 mm). All C2 lamina had a height larger than 3.5 mm and 68.8% (51/74) of C2 lamina had a width thicker than 3.5 mm. For C2 pedicle width, 55.4% (41/74) of cases were larger than 3.5 mm, while 58.1% (43/74) of pedicle heights were larger than 3.5 mm. For pedicle width of subaxial spine, 75.7% (C3), 73% (C4), 82.4% (C5), 89.2% (C6), and 98.1% (C7, 1/54) were greater than 3.5 mm. Mean lamina width of subaxial cervical spine was 3.1 (C3), 2.7 (C4), 2.9 (C5), 3.8 (C6), and 4.0 mm (C7), respectively. Only 34.6% (127/370) of subaxial (C3-7) lamina thickness were greater than 3.5 mm. Mean length of lateral mass for the lateral mass screw placement was 9.28 (C3), 9.08 (C4), 8.81 (C5), 8.98 (C6), and 10.38 mm (C7).
  
  
  CONCLUSIONS
  C1 lateral mass fixation could be limited by the morphometrics of lateral mass height. C2 trans-lamina approach is preferable to C2 pedicle screw fixation. In subaxial spines, pedicle screw placement was preferable to trans-lamina screw placement, except at C7.
authors: Department of Neurosurgery, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
authors: HoJin
authors: H
authors: Lee
authors: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Jae Taek
authors: JT
authors: Hong
authors: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Il Sup
authors: IS
authors: Kim
authors: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Moon Suk
authors: MS
authors: Kim
authors: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Jae Hoon
authors: JH
authors: Sung
authors: Department of Neurosurgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea.
authors: Sang Won
authors: SW
authors: Lee
keywords: Anatomical morphometrics; Cervical spine; Pediatric population; Screw placement
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