Does pedicle screw fixation under age 5 cause spinal canal narrowing? A CT study with minimum 5?years follow-up

摘要

PurposeThe aim of this retrospective study was to evaluate the changes in the vertebral body and spinal canal area in a group of patients who had pedicle screw fixation under age 5 for the treatment of congenital spinal deformity at least 5?year follow-up.Methods11 patients who had been operated due to spinal deformity under age 5 with who had a CT examination at least 5?years after the initial operation were included in the study. All patients underwent hemivertebrectomy and transpedicular fixation procedures at an average age of 3.18?years (range 2–5?years). All had preoperative CT to evaluate the congenital deformities. Measurements were done at the instrumented vertebrae as well as the un-instrumented ones above and below them to evaluate; vertebral body parameters, pedicle parameters and spinal canal area of upper instrumented vertebra (UIV), lower instrumented vertebra (LIV), upper adjacent un-instrumented vertebra and lower adjacent un-instrumented vertebra.ResultsThe average follow-up was 7.2 (range 5–12) years. Six of the patients were over age 10 during the final CT examination while 5 were at age 7. Female-to male ratio was 8–3. Measurement of all the parameters in 22 instrumented and 22 non-instrumented segments showed a proportional increase rather than a decrease at each segment. The percentage of canal area growth at UIV and LIV was 21 and 17.5?%, respectively.ConclusionPedicle screw instrumentation has no adverse effect on further spinal body, pedicle and canal growth and does not result in iatrogenic spinal canal stenosis...