Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (36): 5804-5809.doi: 10.12307/2021.346

Previous Articles     Next Articles

Feasibility of atlantoaxial pedicle screw or lateral mass screw fixation in preschool children

Xiong Feng1, Li Kun2, Zhou Shuyu3, Wang Peng4, Dang Yexing4, Li Zhijun2, Zhang Shaojie2   

  1. 1Ordos Clinical College, 2Department of Human Anatomy, 3College of Traditional Chinese Medicine, 4First Clinical College, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Received:2021-03-05 Revised:2021-03-06 Accepted:2021-04-10 Online:2021-12-28 Published:2021-09-17
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Zhang Shaojie, Professor, Master’s supervisor, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • About author:Xiong Feng, Ordos Clinical College, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Li Kun, Master, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Supported by:
    National Natural Science Foundation of China, No. 81860383 (to LZJ); National Natural Science Foundation of China, No. 81660358 (to ZSJ); Graduate Research and Innovation Fund of Inner Mongolia Autonomous Region, No. S2018112010Z (to LK); Laboratory Open Project of Inner Mongolia Medical University, No. 2020ZN48 (to LK); College Student Innovation and Entrepreneurship Program of Inner Mongolia Medical University, No. 202010132001 (to XF); Inner Mongolia Medical University Enlightenment Program, No. FYQMJH2020034 (to LK); Inner Mongolia Natural Science Foundation of China, No. 2020LH08021 (to LZJ); Inner Mongolia Natural Science Foundation of China, No. 2019MS08017 (to ZSJ); Science and Technology Development Program of Inner Mongolia Autonomous Region, No. 2019GG158 (to LK); Youth Innovation Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK)

PDF

34

Abstract: BACKGROUND: In the treatment of occipitocervical atlas fractures, pedicle or lateral mass internal fixation is usually performed for adult fractures. There are no anatomic data on the development of common internal fixation screws in atlas in pre-school age children.  
OBJECTIVE: To investigate the feasibility of 3.50 mm screw placement in atlas pedicle or lateral mass in 1-6-year-old children by observing morphological structure of atlas.
METHODS:  Head and neck imaging data of 54 children aged 1-6 years were collected from Affiliated Hospital of Inner Mongolia Medical University, Second Affiliated Hospital of Inner Mongolia Medical University and Chifeng Hospital, and divided into three groups (1-2 year-old group, 3-4 year-old group, 5-6 year-old group). Three-dimensional reconstruction was performed by importing DICOM data into MIMICS17.0. All parameters of atlas were measured by measuring tools in image data and reconstruction model, and analyzed statistically.  
RESULTS AND CONCLUSION: (1) Atlas parameters had no statistical difference between left and right sides in each group (P > 0.05). Each index of atlas was on the rise along with the age growth. The pedicle width, pedicle nail into point away from the center line of the horizontal distance, pedicle angle, tail angle, lateral horizontal diameter, side piece into the nail points away from the center line of the horizontal distance, lateral block angle, and the upper tilting angle were statistically significant among groups (P < 0.05). (3) The main limiting factor of pedicle was pedicle width and pedicle height. Measurement results showed that the pedicle width > pedicle height. Pedicle heights were (4.23±0.46), (5.09±0.46), and (5.47±0.69) mm in the 1-2 year-old group, 3-4 year-old group, and 5-6 year-old group, respectively. There was no obvious limitation of lateral mass screws. (4) It is indicated that 3.50 mm screws can be inserted into the pedicle or lateral mass of atlas in children aged 1-6 years, but the angle, position and length should be different in children of different ages. Imaging scan and individualized surgical plan should be carried out for clinical operation.

Key words: children, atlas, digital, CT, anatomical structure, morphological measurement, developmental characteristics, internal fixation

CLC Number: