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Computed Tomographic Morphometric Analysis of the Pediatric Occipital Condyle for Occipital Condyle Screw Placement

Lin, Sheng-Lei MD*; Xia, Dong-Dong MD*; Chen, Wei MD; Li, Yao MD*; Shen, Zhong-Hai MD*; Wang, Xiang-Yang MD, PhD*; Xu, Hua-Zi MD*; Chi, Yong-Long MD*

doi: 10.1097/BRS.0000000000000105
Anatomy

Study Design. This study is a computed tomographic (CT)-based morphometric analysis of the pediatric occipital condyles as related to occipital condyle screw placement.

Objective. To quantify reference data concerning the dimensions of the immature occipital condyles to guide the placement of occipital condyle screw.

Summary of Background Data. To the best of our knowledge, no published study has provided insight into the anatomy of occipital condyle of the pediatric population with different age groups.

Methods. Sixty-nine pediatric patients were divided into 4 age groups, and their occipital condyles were studied on CT scans. Condylar length, width, height, sagittal angle, and sagittal angle lengths were measured on Philips Brilliance 16 CT.

Results. The mean pediatric coronal height, sagittal length, and axial width noted statistically significant age-related differences were 9.0 mm, 21.3 mm, and 9.8 mm, respectively. The mean sagittal angle for all patients was 27.2 ± 5.1° (range, 15.1–41.0°). In 82.6% (114/138) of the occipital condyles, the anatomy could accept the occipital condyle screw (width ≥8 mm and height ≥6.5 mm).

Conclusion. Our investigation provides insight into the anatomy of occipital condyle of the pediatric population with different age groups. As the pediatric occipital condyles have sufficient occipital bone for appropriate fixation or fusion, the occipital condyle screws fixation is a feasible technique for children. Even so, given the evolution of this technique being still in its infancy and the complexity inherent to the craniovertebral junction, a careful radiological analysis of occipital condyle must be required in preoperative planning and feasibility determination.

Level of Evidence: N/A

This study was designed to measure the dimensions of the occipital condyles to guide the use of occipital condyle screws for pediatric patients. The results showed that the pediatric occipital condyles have sufficient occipital bone for appropriate fixation and the occipital condyle screw fixation is a feasible technique for children.

Departments of *Orthopaedic Surgery and

Radiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

Address correspondence and reprint requests to Xiang-Yang Wang, MD, PhD, Department of Orthopaedic Surgery, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuan Xi Rd, Wenzhou, Zhejiang 325027, China; E-mail: xiangyangwang@126.com

Acknowledgment date: February 21, 2013. First revision date: July 21, 2013. Second revision date: October 9, 2013. Acceptance date: October 12, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

National Nature Foundation of China (grant no. 81371988), Natural Science Foundation of Zhejiang Province for Distinguished Young Scholars (grant no. LR12H06001), and Qianjiang Talents Project of Technology Office of Zhejiang Province (grant no. 2010R10075) funds were received in support of this work.

No relevant financial activities outside the submitted work.

© 2014 by Lippincott Williams & Wilkins