Researchers in this study noted no major complications after pedicle screw placement using a modified free-hand technique in pediatric patients.
“The results indicate that in very young children, pedicle screws can be safely implanted using a modified free-hand implantation technique,” Jing Li, MD, and colleagues wrote in their study abstract.
Li and colleagues retrospectively analyzed the results of 16 patients between 1 year and 4 years of age who underwent pedicle screw fixation between T2 and L5 with a total of 74 screws implanted using a modified free-hand method. The investigators assessed the safety and accuracy of this method using postoperative CT scans and X-rays. Patients in the study had preoperative hemivertebra deformity, spinal tuberculosis with kyphotic deformity, eosinophilic granuloma disease with spinal cord compression or neurological defects, according to the abstract. The investigators followed the patients for an average of 30.6 months.
“No patient had any neurological or radicular symptoms related to the placement of pedicle screws,” the authors wrote. Using CT scans, they found five malpositioned pedicle screws: two entered the anterolateral cortical bone of the vertebral body; and one screw each passing through the lateral cortical bone of the pedicle; breaching the anterior vertebral margin; and entering the disc space, according to the abstract.
In seven patients with 3-years to 7-years follow-up, investigators found no indication of halted vertebral growth. According to the abstract, the researchers reported no adverse effects from screw placement, including visceral or vessel complications, or spinal cord damage.