Lateral Mass Screws for Spine Fusion in Children

  • Preferred technique for children: Lateral mass screw fixation is the most common technique used for fusion of the subaxial cervical spine.
  • Less stable than in adults: In children, extremely small screws may be required, necessitating more levels of fixation or consideration of an external orthosis.
  • Angled screw insertion to increase stability: In children, the angled insertion technique of Magerl is usually preferable to the perpendicular Roy-Camille insertion technique (5) as it provides for a slightly longer screw length.
Magerl vs. Roy-Camille technique: Screws enter 2 mm medial and cranial to center point of articulating mass and pass 20¬-25 degrees anterolaterally, parallel to the surface of the intervertebral joints with the Magerl technique (left-sided images). The entry point and trajectory of the Roy-Camille technique is shown on the right for comparison (5).