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

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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.

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References

  1. 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 67:157–163

    CAS  PubMed  Google Scholar 

  2. 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 28:2058–2065

    Article  PubMed  Google Scholar 

  3. Kim YJ, Lenke LG, Bridwell KH, Cho YS, Riew KD (2004) Free hand pedicle screw placement in the thoracic spine: is it safe? Spine 29:333–342

    Article  PubMed  Google Scholar 

  4. 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 11:336–343

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. 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 31:291–298

    Article  PubMed  Google Scholar 

  6. 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 31:2400–2404

    Article  PubMed  Google Scholar 

  7. 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–E393

    Article  PubMed  Google Scholar 

  8. 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 11:323–328

    Article  CAS  PubMed  Google Scholar 

  9. 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. Yamazaki A, Mason DE, Caro PA (1998) Age of closure of the neurocentral cartilage in the thoracic spine. J Pediatr Orthop 18:168–172

    CAS  PubMed  Google Scholar 

  11. Rajwani T, Bhargava R, Moreau M, Mahood J, Raso VJ, Jiang H, Bagnall KM (2002) MRI characteristics of the neurocentral synchondrosis. Pediatr Radiol 32:811–816

    Article  CAS  PubMed  Google Scholar 

  12. 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 91:235–240

    CAS  PubMed  Google Scholar 

  13. 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

    Google Scholar 

  14. 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):1892–1898

    Article  PubMed Central  PubMed  Google Scholar 

  15. 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. 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 77:1193–1199

    CAS  PubMed  Google Scholar 

  17. 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 77:1200–1206

    CAS  PubMed  Google Scholar 

  18. Suk SI, Kim W, Lee S et al (2001) Thoracic pedicle screw fixation in spinal deformity: are they really safe? Spine 26:2049–2057

    Article  CAS  PubMed  Google Scholar 

  19. 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 27:1558–1566

    Article  PubMed  Google Scholar 

  20. Ruf M, Harms J (2002) Pedicle screws in 1- and 2-year-old children: technique, complications, and effect on further growth. Spine 27:E460–E466

    Article  PubMed  Google Scholar 

  21. 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–E52

    Article  PubMed  Google Scholar 

  22. 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 37:1778–1784

    Article  PubMed  Google Scholar 

  23. 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 35:76–82

    Article  PubMed  Google Scholar 

  24. 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. Zindrick MR, Knight GW, Sartori MJ, Carnevale TJ, Patwardhan AG, Lorenz MA (2000) Pedicle morphology of the immature thoracolumbar spine. Spine 25:2726–2735

    Article  CAS  PubMed  Google Scholar 

  26. Porter RW, Pavitt D (1987) The vertebral canal: I. Nutrition and development, an archaeological study. Spine 12:901–906

    Article  CAS  PubMed  Google Scholar 

  27. Dimeglio A (2001) Growth in pediatric orthopaedics. J Pediatr Orthop 21:549–555

    CAS  PubMed  Google Scholar 

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Acknowledgments

This work was supported by the National Natural Science Foundation of China (81272053).

Conflict of interest

The authors declare that they have no conflict of interests related to this work.

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Authors and Affiliations

  1. Department of Orthopedics, Peking Union Medical College Hospital, Peking Union Medical College, No. 1 Shuai Fu Yuan, Wang Fu Jing Street, Beijing, 100730, China

    Xuhong Xue, Jianxiong Shen, Jianguo Zhang, Shugang Li, Yipeng Wang & Guixing Qiu

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  1. Xuhong Xue
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  2. Jianxiong Shen
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  3. Jianguo Zhang
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  4. Shugang Li
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Correspondence to Jianxiong Shen.

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Xue, X., Shen, J., Zhang, J. et al. X-Ray assessment of the effect of pedicle screw on vertebra and spinal canal growth in children before the age of 7 years. Eur Spine J 23, 520–529 (2014). https://doi.org/10.1007/s00586-013-3035-7

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  • DOI: https://doi.org/10.1007/s00586-013-3035-7

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