The ISPN Guide to Pediatric Neurosurgery

HomeSpinal Diseases and Anomalies in ChildrenCervical Spine Trauma in Children HomepageManagement of Cervical Spine Trauma in ChildrenThe Operation for Cervical Spine Trauma in ChildrenLateral Mass Screws for Spine Fusion in Children

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).

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