Image Guidance to Aid Pedicle Screw Fixation of a Lumbar Fracture-Dislocation Injury in a Toddler

John K. Houten, Jonathan Nahkla, Shashank Ghandi

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background Pedicle 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 Description A 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. Conclusions Image-guided placement of pedicle screws may be a useful aid in achieving accurate and safe fixation in the small dimensions of the infant spine.

Original languageEnglish
Pages (from-to)1041.e15-1041.e17
JournalWorld Neurosurgery
StatePublished - Sep 2017
Externally publishedYes


  • Neuronavigation
  • O-arm
  • Pediatric spine
  • Pedicle screw
  • Spinal fracture


Dive into the research topics of 'Image Guidance to Aid Pedicle Screw Fixation of a Lumbar Fracture-Dislocation Injury in a Toddler'. Together they form a unique fingerprint.

Cite this