Skip to main content
Erschienen in: European Spine Journal 3/2014

01.03.2014 | Original Article

X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years

verfasst von: Xuhong Xue, Jianxiong Shen, Jianguo Zhang, Shugang Li, Yipeng Wang, Guixing Qiu

Erschienen in: European Spine Journal | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine the reliability of pedicle screws placed in children younger than 7 years of age, and to evaluate the effect of pedicle screw insertion on further growth of the vertebra and spinal canal.

Methods

A retrospective study of 35 consecutive patients through Jan 2003–Dec 2010 for congenital scoliosis in <7 years children was performed at one spine center. Patients undergoing pedicle screw instrumentation of at least two levels, which had been followed-up for at least 24 months were included. Measurements were performed in instrumented and adjacent non-instrumented levels. The effect of pedicle screw insertion on further growth was evaluated.

Results

The average age at surgery was 4.4 year (53 months, range, 23–84 months). 190 segments in 35 patients met the inclusion criteria. 77 segments had no screws and 113 had at least one screw. There was a significant difference between the pre-operative and final follow-up values of the measurement of spinal canal and vertebral body parameters (P < 0.001). No significant difference existed between growth rates of vertebral bodies and the sagittal diameters of spinal canal with or without screws. The growth rates of vertebral bodies in lumbar spine were higher than in thoracic spine in both instrumented and adjacent groups.

Conclusion

Pedicle screw instrumentation does not cause a retardation effect on the development of vertebral bodies and the spinal canal in children at an early age. It is a safe and reliable procedure to achieve a stable fixation.
Literatur
1.
Zurück zum Zitat Liljenqvist U, Hackenberg L, Link T, Halm H (2001) Pullout strength of pedicle screws versus pedicle and laminar hooks in the thoracic spine. Acta Orthop Belg 67:157–163PubMed Liljenqvist U, Hackenberg L, Link T, Halm H (2001) Pullout strength of pedicle screws versus pedicle and laminar hooks in the thoracic spine. Acta Orthop Belg 67:157–163PubMed
2.
Zurück zum Zitat Lehman RA Jr, Polly DW Jr, Kuklo TR, Cunningham B, Kirk KL, Belmont PJ Jr (2003) Straight-forward versus anatomic trajectory technique of thoracic pedicle screw fixation: a biomechanical analysis. Spine 28:2058–2065PubMedCrossRef Lehman RA Jr, Polly DW Jr, Kuklo TR, Cunningham B, Kirk KL, Belmont PJ Jr (2003) Straight-forward versus anatomic trajectory technique of thoracic pedicle screw fixation: a biomechanical analysis. Spine 28:2058–2065PubMedCrossRef
3.
Zurück zum Zitat Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD (2004) Free hand pedicle screw placement in the thoracic spine: is it safe? Spine 29:333–342PubMedCrossRef Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD (2004) Free hand pedicle screw placement in the thoracic spine: is it safe? Spine 29:333–342PubMedCrossRef
4.
Zurück zum Zitat Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343PubMedCentralPubMedCrossRef Liljenqvist U, Lepsien U, Hackenberg L, Niemeyer T, Halm H (2002) Comparative analysis of pedicle screw and hook instrumentation in posterior correction and fusion of idiopathic thoracic scoliosis. Eur Spine J 11:336–343PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, Sides B (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine 31:291–298PubMedCrossRef Kim YJ, Lenke LG, Kim J, Bridwell KH, Cho SK, Cheh G, Sides B (2006) Comparative analysis of pedicle screw versus hybrid instrumentation in posterior spinal fusion of adolescent idiopathic scoliosis. Spine 31:291–298PubMedCrossRef
6.
Zurück zum Zitat Dobbs MB, Lenke LG, Kim YJ, Kamath G, Peelle MW, Bridwell KH (2006) Selective posterior thoracic fusions for adolescent idiopathic scoliosis: comparison of hooks versus pedicle screws. Spine 31:2400–2404PubMedCrossRef Dobbs MB, Lenke LG, Kim YJ, Kamath G, Peelle MW, Bridwell KH (2006) Selective posterior thoracic fusions for adolescent idiopathic scoliosis: comparison of hooks versus pedicle screws. Spine 31:2400–2404PubMedCrossRef
7.
Zurück zum Zitat Baghdadi YM, Larson AN, McIntosh AL, Shaughnessy WJ, Dekutoski MB, Stans AA (2013) Complications of pedicle screws in children 10 years or younger: a case control study. Spine 38:E386–E393PubMedCrossRef Baghdadi YM, Larson AN, McIntosh AL, Shaughnessy WJ, Dekutoski MB, Stans AA (2013) Complications of pedicle screws in children 10 years or younger: a case control study. Spine 38:E386–E393PubMedCrossRef
8.
Zurück zum Zitat Vital JM, Beguiristain JL, Algara C, Villas C, Lavignolle B, Grenier N, Sénégas J (1989) The neurocentral vertebral cartilage: anatomy, physiology and physiopathology. Surg Radiol Anat 11:323–328PubMedCrossRef Vital JM, Beguiristain JL, Algara C, Villas C, Lavignolle B, Grenier N, Sénégas J (1989) The neurocentral vertebral cartilage: anatomy, physiology and physiopathology. Surg Radiol Anat 11:323–328PubMedCrossRef
9.
Zurück zum Zitat Maat GJ, Matricali B, van Persijn van Meerten EL (1996) Postnatal development and structure of the neurocentral junction. Its relevance for spinal surgery. Spine 21: 661–666 Maat GJ, Matricali B, van Persijn van Meerten EL (1996) Postnatal development and structure of the neurocentral junction. Its relevance for spinal surgery. Spine 21: 661–666
10.
Zurück zum Zitat Yamazaki A, Mason DE, Caro PA (1998) Age of closure of the neurocentral cartilage in the thoracic spine. J Pediatr Orthop 18:168–172PubMed Yamazaki A, Mason DE, Caro PA (1998) Age of closure of the neurocentral cartilage in the thoracic spine. J Pediatr Orthop 18:168–172PubMed
11.
Zurück zum Zitat Rajwani T, Bhargava R, Moreau M, Mahood J, Raso VJ, Jiang H, Bagnall KM (2002) MRI characteristics of the neurocentral synchondrosis. Pediatr Radiol 32:811–816PubMedCrossRef Rajwani T, Bhargava R, Moreau M, Mahood J, Raso VJ, Jiang H, Bagnall KM (2002) MRI characteristics of the neurocentral synchondrosis. Pediatr Radiol 32:811–816PubMedCrossRef
12.
Zurück zum Zitat Rajwani T, Hilang EM, Secretan C, Bhargava R, Lambert R, Moreau M, Mahood J, Raso VJ, Bagnall KM (2002) The components of the magnetic resonance image of the neurocentral junction. Stud Health Technol Inform 91:235–240PubMed Rajwani T, Hilang EM, Secretan C, Bhargava R, Lambert R, Moreau M, Mahood J, Raso VJ, Bagnall KM (2002) The components of the magnetic resonance image of the neurocentral junction. Stud Health Technol Inform 91:235–240PubMed
13.
Zurück zum Zitat Cil A, Yazici M, Daglioglu K, Aydingoz U, Alanay A, Acaroglu RE, Gulsen M, Surat A (2005) The effect of pedicle screw placement with or without application of compression across the neurocentral cartilage on the morphology of the spinal canal and pedicle in immature pigs. Spine (Phila Pa 1976). 30(11):1287–1293 Cil A, Yazici M, Daglioglu K, Aydingoz U, Alanay A, Acaroglu RE, Gulsen M, Surat A (2005) The effect of pedicle screw placement with or without application of compression across the neurocentral cartilage on the morphology of the spinal canal and pedicle in immature pigs. Spine (Phila Pa 1976). 30(11):1287–1293
14.
Zurück zum Zitat Fekete TF, Kleinstück FS, Mannion AF, Kendik ZS, Jeszenszky DJ (2011) Prospective study of the effect of pedicle screw placement on development of the immature vertebra in an in vivo porcine model. Eur Spine J 20(11):1892–1898PubMedCentralPubMedCrossRef Fekete TF, Kleinstück FS, Mannion AF, Kendik ZS, Jeszenszky DJ (2011) Prospective study of the effect of pedicle screw placement on development of the immature vertebra in an in vivo porcine model. Eur Spine J 20(11):1892–1898PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Yilmaz G, Demirkiran G, Ozkan C, Daglioglu K, Pekmezci M, Alanay A, Yazici M (2009) The effect of dilation of immature pedicles on pullout strength of the screws: part 2: In vivo study. Spine (Phila Pa 1976). 34(22):2378–2383 Yilmaz G, Demirkiran G, Ozkan C, Daglioglu K, Pekmezci M, Alanay A, Yazici M (2009) The effect of dilation of immature pedicles on pullout strength of the screws: part 2: In vivo study. Spine (Phila Pa 1976). 34(22):2378–2383
16.
Zurück zum Zitat Vaccaro AR, Rizzolo SJ, Allardyce TJ et al (1995) Placement of pedicle screws in the thoracic spine. Part I: morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am 77:1193–1199PubMed Vaccaro AR, Rizzolo SJ, Allardyce TJ et al (1995) Placement of pedicle screws in the thoracic spine. Part I: morphometric analysis of the thoracic vertebrae. J Bone Joint Surg Am 77:1193–1199PubMed
17.
Zurück zum Zitat Vaccaro AR, Rizzolo SJ, Balderston RA et al (1995) Placement of pedicle screws in the thoracic spine. Part II: an anatomical and radiographic assessment. J Bone Joint Surg Am 77:1200–1206PubMed Vaccaro AR, Rizzolo SJ, Balderston RA et al (1995) Placement of pedicle screws in the thoracic spine. Part II: an anatomical and radiographic assessment. J Bone Joint Surg Am 77:1200–1206PubMed
18.
Zurück zum Zitat Suk SI, Kim W, Lee S et al (2001) Thoracic pedicle screw fixation in spinal deformity: are they really safe? Spine 26:2049–2057PubMedCrossRef Suk SI, Kim W, Lee S et al (2001) Thoracic pedicle screw fixation in spinal deformity: are they really safe? Spine 26:2049–2057PubMedCrossRef
19.
Zurück zum Zitat Belmont PJ Jr, Klemme WR, Robinson M et al (2002) Accuracy of thoracic pedicle screws in patients with and without coronal plane spinal deformities. Spine 27:1558–1566PubMedCrossRef Belmont PJ Jr, Klemme WR, Robinson M et al (2002) Accuracy of thoracic pedicle screws in patients with and without coronal plane spinal deformities. Spine 27:1558–1566PubMedCrossRef
20.
Zurück zum Zitat Ruf M, Harms J (2002) Pedicle screws in 1- and 2-year-old children: technique, complications, and effect on further growth. Spine 27:E460–E466PubMedCrossRef Ruf M, Harms J (2002) Pedicle screws in 1- and 2-year-old children: technique, complications, and effect on further growth. Spine 27:E460–E466PubMedCrossRef
21.
Zurück zum Zitat Li J, Lü GH, Wang B, Wang XB, Lu C, Kang YJ (2013) Pedicle screw implantation in the thoracic and lumbar spine of 1-4-year-old children: evaluating the safety and accuracy by a computer tomography follow-up. J Spinal Disord Tech 26(2):E46–E52PubMedCrossRef Li J, Lü GH, Wang B, Wang XB, Lu C, Kang YJ (2013) Pedicle screw implantation in the thoracic and lumbar spine of 1-4-year-old children: evaluating the safety and accuracy by a computer tomography follow-up. J Spinal Disord Tech 26(2):E46–E52PubMedCrossRef
22.
Zurück zum Zitat Olgun ZD, Demirkiran G, Ayvaz M, Karadeniz E, Yazici M (2012) The effect of pedicle screw insertion at a young age on pedicle and canal development. Spine 37:1778–1784PubMedCrossRef Olgun ZD, Demirkiran G, Ayvaz M, Karadeniz E, Yazici M (2012) The effect of pedicle screw insertion at a young age on pedicle and canal development. Spine 37:1778–1784PubMedCrossRef
23.
Zurück zum Zitat Zhang H, Sucato DJ, Nurenberg P, McClung A (2010) Morphometric analysis of neurocentral synchondrosis using magnetic resonance imaging in the normal skeletally immature spine. Spine 35:76–82PubMedCrossRef Zhang H, Sucato DJ, Nurenberg P, McClung A (2010) Morphometric analysis of neurocentral synchondrosis using magnetic resonance imaging in the normal skeletally immature spine. Spine 35:76–82PubMedCrossRef
24.
Zurück zum Zitat Ginsburg G, Schwend R (2010) Neurocentral synchondrosis behavior in cadaveric vertebrae in skeletally immature spines. In: Paper presented at: fourth international congress on early onset scoliosis and growing spine; Toronto, Canada Ginsburg G, Schwend R (2010) Neurocentral synchondrosis behavior in cadaveric vertebrae in skeletally immature spines. In: Paper presented at: fourth international congress on early onset scoliosis and growing spine; Toronto, Canada
25.
Zurück zum Zitat Zindrick MR, Knight GW, Sartori MJ, Carnevale TJ, Patwardhan AG, Lorenz MA (2000) Pedicle morphology of the immature thoracolumbar spine. Spine 25:2726–2735PubMedCrossRef Zindrick MR, Knight GW, Sartori MJ, Carnevale TJ, Patwardhan AG, Lorenz MA (2000) Pedicle morphology of the immature thoracolumbar spine. Spine 25:2726–2735PubMedCrossRef
26.
Zurück zum Zitat Porter RW, Pavitt D (1987) The vertebral canal: I. Nutrition and development, an archaeological study. Spine 12:901–906PubMedCrossRef Porter RW, Pavitt D (1987) The vertebral canal: I. Nutrition and development, an archaeological study. Spine 12:901–906PubMedCrossRef
27.
Zurück zum Zitat Dimeglio A (2001) Growth in pediatric orthopaedics. J Pediatr Orthop 21:549–555PubMed Dimeglio A (2001) Growth in pediatric orthopaedics. J Pediatr Orthop 21:549–555PubMed
Metadaten
Titel
X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years
verfasst von
Xuhong Xue
Jianxiong Shen
Jianguo Zhang
Shugang Li
Yipeng Wang
Guixing Qiu
Publikationsdatum
01.03.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 3/2014
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-013-3035-7

Weitere Artikel der Ausgabe 3/2014

European Spine Journal 3/2014 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.