• John K Houten, Jonathan Nahkla, and Shashank Ghandi.
• Department of Neurosurgery, Montefiore Medical Center, Bronx, New York, USA; Department of Neurosurgery, Hofstra-Northwell School of Medicine, Hampstead, New York, USA. Electronic address: jkhmd@yahoo.com.
• World Neurosurg. 2017 Sep 1; 105: 1041.e15-1041.e17.

BackgroundPedicle screw fixation of the lumbar spine in children age <2 years is particularly challenging, as successful cannulation of the small pedicle dimensions requires a high level of precision and there are no implants specifically designed for the infant spine. Image-guided navigation is commonly used in adult spinal surgery and may be particularly helpful for the placement of spinal screws in areas where the bony anatomy is small and/or anatomically complex, as in the upper cervical area.Case DescriptionA 19-month-old female presented with a fracture-dislocation injury of L1-2. Intraoperative imaging using the O-arm multidimensional imaging system was networked to a workstation, and neuronavigation was used to place pedicle instrumentation with 3.5-mm-diameter polyaxial screws designed for posterior cervical fixation. At a 48-month follow-up, the patient was neurologically intact, demonstrated normal physical development, and was engaging in normal physical activity for her age. Radiographs obtained approximately 4 years postsurgery showed no evidence of loss for fixation.ConclusionsImage-guided placement of pedicle screws may be a useful aid in achieving accurate and safe fixation in the small dimensions of the infant spine.Copyright © 2017 Elsevier Inc. All rights reserved.

28 keywords...

hide…