Modern cervical spine instrumentation in children

Study Design. A retrospective case series. Objective. To determine the safety, efficacy, and feasibility of using modern segmental cervical spine instrumentation in children. Summary of Background Data. With the exception of transarticular screws, there are currently no series in the literature looking at the use of modern cervical spine implants in children. In the adult population, these implants have been shown to be biomechanically superior to traditional wiring methods. These constructs may also decrease the need for postoperative halo immobilization, while at the same time improving arthrodesis rates. Methods. A retrospective review of 25 pediatric patients greater than 6 years of age treated at our institution with modern segmental instrumentation of the cervical spine. Computed tomography scans were evaluated to determine containment of screws. Radiographic and chart review was done to determine the clinical outcome with respect to fusion and any complications related to surgery. Results. There were no implant related complications in this series. All screws (n = 112) evaluated by computed tomography scan were fully contained. All patients obtained union and there were no reoperations related to the spinal implants. Complications included: 1 deep infection, 1 superficial infection, and 1 transient radiculopathy. Conclusion. Modern cervical spine instrumentation is safe and feasible to use in children older than 6 years of age. The clinical union rate in our series was 100% with no implant related complications.