Cervical Spine Instrumentation in Children.
Instrumentation of the cervical spine enhances stability and improves arthrodesis rates in children undergoing surgery for deformity or instability. Various morphologic and clinical studies have been conducted in children, confirming the feasibility of anterior or posterior instrumentation of the cervical spine with modern implants. Knowledge of the relevant spine anatomy and preoperative imaging studies can aid the clinician in understanding the pitfalls of instrumentation for each patient. Preoperative planning, intraoperative positioning, and adherence to strict surgical techniques are required given the small size of children. Instrumentation options include anterior plating, occipital plating, and a variety of posterior screw techniques. Complications related to screw malposition include injury to the vertebral artery, neurologic injury, and instrumentation failure.
From the Department of Orthopedic Surgery, Children's Hospital, Harvard Medical School, Boston, MA.
Daniel J
DJ
Hedequist
John B
JB
Emans
D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001860:Bone Plates; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D006801:Humans; D056888:Patient Positioning; D011183:Postoperative Complications / Q000209:etiology