{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T04:14:43Z","timestamp":1789618483312,"version":"build-2803163510"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2012,11]]},"abstract":"\nObject<\/jats:title>\nLateral mass screws are routinely placed throughout the subaxial cervical spine in adults, but there are few clinical or radiographic studies regarding lateral mass fixation in children. The morphology of pediatric cervical lateral masses may be associated with greater difficulty in obtaining adequate purchase. The authors examined the lateral masses of the subaxial cervical spine in pediatric patients to define morphometric differences compared with adults, establish guidelines for lateral mass instrumentation in children, and define potential limitations of this technique in the pediatric age group.<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nMorphometric analysis was performed on CT of the lateral masses of C3\u20137 in 56 boys and 14 girls. Measurements were obtained in the axial, coronal, and sagittal planes.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nFor most levels and measurements, results in boys and girls did not differ significantly; the few values that were significantly different are not likely to be clinically significant. On the other hand, younger (< 8 years of age) and older children (\u2265 8 years of age) differed significantly at every level and measurement except for facet angularity. Sagittal diagonal, a measurement that closely estimates screw length, was found to increase at each successive caudal level from C-3 to C-7, similar to the adult population. A screw acceptance analysis found that all patients \u2265 4 years of age could accept at least a 3.5 \u00d7 10 mm lateral mass screw.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nLateral mass screw fixation is feasible in the pediatric cervical spine, particularly in children age 4 years old or older. Lateral mass screw fixation is feasible even at the C-7 level, where pedicle screw placement has been advised in lieu of lateral mass screws because of the small size and steep trajectory of the C-7 lateral mass. Nonetheless, all pediatric patients should undergo high-resolution, thin-slice CT preoperatively to assess suitability for lateral mass screw fixation.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.8.spine12767","type":"journal-article","created":{"date-parts":[[2012,9,15]],"date-time":"2012-09-15T05:28:56Z","timestamp":1347686936000},"page":"390-396","source":"Crossref","is-referenced-by-count":17,"title":["Computed tomography morphometric analysis for lateral mass screw placement in the pediatric subaxial cervical spine"],"prefix":"10.3171","volume":"17","author":[{"given":"George","family":"Al-Shamy","sequence":"first","affiliation":[{"name":"Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas and;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Cherian","sequence":"additional","affiliation":[{"name":"Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas and;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier A.","family":"Mata","sequence":"additional","affiliation":[{"name":"Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas and;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash J.","family":"Patel","sequence":"additional","affiliation":[{"name":"Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas and;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven W.","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Floating Children's Hospital, Department of Neurosurgery, Tufts University, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Jea","sequence":"additional","affiliation":[{"name":"Neuro-Spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, and Department of Neurosurgery, Baylor College of Medicine, Houston, Texas and;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine12767","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1097\/BRS.0b013e3181a8f649","article-title":"Morphometric and volumetric analysis of the lateral masses of the lower cervical spine","volume":"34","author":"Abdullah","year":"2009"},{"issue":"10 Suppl","key":"b2-spine12767","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S548","DOI":"10.1097\/00007632-199110001-00019","article-title":"Anatomic considerations for plate-screw fixation of the cervical 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