eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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vol. 13
Original paper

Three-dimensional digitizing and anatomic study of lumbar vertebral canal and pedicle in children

Xing Wang, Shao-Jie Zhang, Yuan-Zhi Zhang, Xiao-He Li, Zhi-Feng Zhang, Chao-Qun Wang, Shang Gao, Jun Shi, Zhi-Jun Li

Videosurgery Miniinv 2018; 13 (4): 518–524
Online publish date: 2018/08/08
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Spinal pedicle screw internal fixation has been widely used in adult spine injury fixation. Due to being in a period of continuous growth and development, the spine of children at different ages shows different characteristics from adults in terms of anatomy, physiological function, and biomechanics. Furthermore, because the pedicle of children is small, has large anatomic variation, and has complex adjacent relationships, the surgical risk is extremely high. How to improve the screwing accuracy is the key to the success of children’s pedicle internal fixation. Therefore, applying the concept of digitized and individualized screwing will be of great significance to children’s pedicle screwing.

To investigate the morphologies, development patterns, and aging characteristics of the lumbar vertebral pedicle (LVP) in children aged 6–11 years, and to provide a theoretical basis for screw implantation and related biomechanical studies.

Material and Methods
A total of 60 children aged 6–11 years were selected for the intergroup measurement and statistical analysis of their lumbar diameter, pedicle diameter, screw canal length (SCL), etc.

Generally, the vertebral foramen diameter (ID), sagittal diameter (SD), pedicle width (PW), and SCL as well as the pedicle height (PH) exhibited an increasing trend with age and increasing vertebral sequence among children aged 6–11 years.

By observing the LVP in children using 3D digital reconstruction technology, the morphology of the spinal canal and pedicles at different lumbar segments showed obvious development patterns, and the best treatment protocol should be selected according to the LVP characteristics in clinical applications.


lumbar vertebra, pedicle, morphologic characteristics, 3D reconstruction measurement, children

Menger RP, Storey CM, Nixon MK, et al. Implantation of C1 pedicle screws using minimal exposure: radiographic, clinical, and literature validation. Int J Spine Surg 2015; 9: 43.
Mendelsohn D, Dea N, Lee R, et al. Bilateral pedicle and crossed translaminar screws in C2. Asian Spine J 2015; 9: 783-8.
Zhang Z, Mu Z, Zheng W. Anterior pedicle screw and plate fixation for cervical facet dislocation: case series and technical note. Spine J 2016; 16: 123-9.
Stulik J, Vyskocil T, Sebesta P, et al. Atlantoaxial fixation using the polyaxial screw-rod system. Eur Spine J 2007; 16: 479-84.
Mueller TL, Miller NH, Baulesh DM, et al. The safety of spinal pedicle screws in children ages 1 to 12. Spine J 2013; 13: 894-901.
Ruf M, Harm J. Pedicle screws in 1-and 2-year-old children: technique, complication, and effect on further growth. Spine (Phila Pa 1976) 2002; 27: 460-6.
Fujimori T, Yaszay B, Bartley CE, et al. Safety of pedicle screws and spinal instrumentation for pediatric patients: comparative analysis between 0- and 5-year-old, 5- and 10-year-old, and 10- and 15-year-old patients. Spine 2014; 39: 541-9.
Chan CY, Kwan MK, Saw LB. Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation. Eur Spine J 2010; 19: 78-84.
Ruf M, Harms J. Posterior hemivertebra resection with transpedicular instrumentation: early correction in children aged l to 6 years. Spine (Phila Pa 1976) 2003; 28: 2132-8.
Platzer P, Jaindl M, Thalhammer G, et al. Cervical spine injuries in pediatric patients. J Trauma 2007; 62: 389-96.
Polly DW, Potter BK, Kuklo T, et al. Volumetric spinal canal intrusion: a comparison between thoracic pedicle screws and thoracic hooks. Spine 2004; 29: 59-63.
Wang S, Qiu Y, Liu W, et al. The potential risk of spinal cord injury from pedicle screw at the apex of adolescent idiopathic thoracic scoliosis: magnetic resonance imaging evaluation. BMC Musculoskelet Disord 2015; 16: 310.
Sarwahi V, Sugarman EP, Wollowick AL, et al. Prevalence, dis­tribution, and surgical relevance of abnormal pedicles in spines with adolescent idiopathic scoliosis vs no deformity: a CT-based study. J Bone Joint Surg Am 2014; 96: e92.
Hedequist DJ, Hall JE, Emans JB. The safety and efficacy of spinal instrumentation in children with congenital spine deformities. Spine (Phila Pa 1976) 2004; 29: 2081-6.
Ferree BA. Morphometric characteristics of the immature spine. Spine (Phila Pa 1976) 1992; 17: 887-91.
Li XH, Cai YQ, Wang X, et al. Anatomical characteristics of infra-lamina ridge in Chinese population. Int J Morphol 2014; 32: 432-7.
Tacar O, Demirant A, Nas K, et al. Morphology of the lumbar spinal canal in normal adult turks. Yonsei Med J 2003; 44: 679-85.
Santiago FR, Milena GL, Herrera RO, et al. Morphometry of the lower lumbar vertebrae in patients with and without low back pain. Eur Spine J 2001; 10: 228-33.
Zindrick MR, Wiltse LL, Doornlk A, et al. Analysis of the morphometric characteristics of the thoracic and lumbar pedicles. Spine (Phila Pa 1976) 1987; 12: 160-6.
Chen KR, Liu SS. Anatomical investigation on the internal structure of lumbar pedicle. Sichuan J Anatomy 2007; 5: 27-8.
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