Shao-Jie Zhang1,2, Kun Li2,3, Zhi-Jun Li2,3, Xing Wang2,3, Jia-Hui Dong4, Jian Wang2, Jie Chen2, Xing-Yue Qu2, Zi-Yu Li2, Yu-Hang Liu2. 1. School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People's Republic of China. 2. Department of Human Anatomy, Inner Mongolia Medical University, Hohhot, People's Republic of China. 3. Digital Medical Center, Inner Mongolia Medical University, Hohhot, People's Republic of China. 4. The First Clinical Medical College, Inner Mongolia Medical University, Hohhot, People's Republic of China.
Abstract
OBJECTIVE: This study aimed to investigate the safety of clival screw placement in children aged 1-6 years. METHODS: The cranial computed tomography data of 92 children aged 1-6 years were divided into three groups, according to age, for three-dimensional reconstruction. Three clival screw placement points were defined: (1) median point A at the middle and upper third of the tripartite distance from the spheno-occipital synchondrosis to the base of the skull; (2, 3) critical points B and C on the horizontal line with point A, where the screw placement passage was parallel to the sagittal plane. Parameters such as the passage length and angle were measured for horizontal, vertical facial, and extreme screw placement. RESULTS: The length parameters of the clival screw placement increased with age, and the screw passage length was the shortest for the vertical facial type in each age group. There were significant differences in all three groups between the length of screw placement in the vertical bone surface, the length of screw placement in the horizontal direction, and the length of screw placement on the limit at points A, B, and C (P < 0.05); the length of screw placement on the vertical bone surface was the shortest. There was no significant difference between the horizontal screw length at point A and the extreme screw length (P > 0.05). The difference between the horizontal screw length and the extreme screw length in the groups aged 1-2 years and 5-6 years was statistically significant (P < 0.05), and the horizontal screw length was longer. CONCLUSION: The cranial slope of children aged 1-6 years has the morphological basis for the placement of 3.5 mm screws, and each placement point has a safe angle range for screw placement.
OBJECTIVE: This study aimed to investigate the safety of clival screw placement in children aged 1-6 years. METHODS: The cranial computed tomography data of 92 children aged 1-6 years were divided into three groups, according to age, for three-dimensional reconstruction. Three clival screw placement points were defined: (1) median point A at the middle and upper third of the tripartite distance from the spheno-occipital synchondrosis to the base of the skull; (2, 3) critical points B and C on the horizontal line with point A, where the screw placement passage was parallel to the sagittal plane. Parameters such as the passage length and angle were measured for horizontal, vertical facial, and extreme screw placement. RESULTS: The length parameters of the clival screw placement increased with age, and the screw passage length was the shortest for the vertical facial type in each age group. There were significant differences in all three groups between the length of screw placement in the vertical bone surface, the length of screw placement in the horizontal direction, and the length of screw placement on the limit at points A, B, and C (P < 0.05); the length of screw placement on the vertical bone surface was the shortest. There was no significant difference between the horizontal screw length at point A and the extreme screw length (P > 0.05). The difference between the horizontal screw length and the extreme screw length in the groups aged 1-2 years and 5-6 years was statistically significant (P < 0.05), and the horizontal screw length was longer. CONCLUSION: The cranial slope of children aged 1-6 years has the morphological basis for the placement of 3.5 mm screws, and each placement point has a safe angle range for screw placement.
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