ANATOMIC-ANTHROPOMETRIC BASIS OF TRANSPEDICULAR FIXATION IN CHILDREN OF 1.5–5 YEARS OLD

Abstract

Objective. To reveal anatomic peculiarities of the posterior spine support structures and basic landmarks suitable for transpedicular fixation in children of 1.5–5 years old. Material and Methods. Anatomic and anthropometric studies of 18 cadaveric lumbar spines harvested from objects whose death was not related to spine pathology were carried out. Three age groups were singled out (of 1.5–2.5; 2.5–3.5 and 3.5–5 years old). The anatomic peculiarities of posterior support elements, spatial location of the processes and base of the neural arch were examined and a zone for transpedicular screws insertion was determined. Results. It was revealed that a structure of the posterior support column in children of 1.5–5 years old differs from that in adolescents and adults. Arch articulations are formed by cartilaginous articular processes. There are no bony transverse processes in 2–3-years-old children. 50 % of 4–5-years old children have cartilaginous transverse processes which are not sharply defined during skeletonization. A zone of transpedicular screw insertion is 2–3 mm medial of the middle distance between upper and lower processes of the vertebra. Pedicle angle of inclination of a base of the neural arch to sagittal axis in a horizontal plane varies from 5° at L1 to 20° at L5. Conclusion. Anthropometric measurements serve as basis for development of metal constructions for correction and fixation of the lumbar spine with transpedicular support elments in children of 1.5–5 years old.