{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:32:38Z","timestamp":1761823958308},"reference-count":27,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>Thoracic and lumbar cortical bone trajectory pedicle screws have been described in adult spine surgery. They have likewise been described in pediatric CT-based morphometric studies; however, clinical experience in the pediatric age group is limited. The authors here describe the use of cortical bone trajectory pedicle screws in posterior instrumented spinal fusions from the upper thoracic to the lumbar spine in 12 children. This dedicated study represents the initial use of cortical screws in pediatric spine surgery.<\/jats:p><jats:p>The authors retrospectively reviewed the demographics and procedural data of patients who had undergone posterior instrumented fusion using thoracic, lumbar, and sacral cortical screws in children for the following indications: spondylolysis and\/or spondylolisthesis (5 patients), unstable thoracolumbar spine trauma (3 patients), scoliosis (2 patients), and tumor (2 patients).<\/jats:p><jats:p>Twelve pediatric patients, ranging in age from 11 to 18 years (mean 15.4 years), underwent posterior instrumented fusion. Seventy-six cortical bone trajectory pedicle screws were placed. There were 33 thoracic screws and 43 lumbar screws. Patients underwent surgery between April 29, 2015, and February 1, 2016. Seven (70%) of 10 patients with available imaging achieved a solid fusion, as assessed by CT. Mean follow-up time was 16.8 months (range 13\u201322 months). There were no intraoperative complications directly related to the cortical bone trajectory screws. One patient required hardware revision for caudal instrumentation failure and screw-head fracture at 3 months after surgery.<\/jats:p><jats:p>Mean surgical time was 277 minutes (range 120\u2013542 minutes). Nine of the 12 patients received either a 12- or 24-mg dose of recombinant human bone morphogenic protein 2. Average estimated blood loss was 283 ml (range 25\u20131100 ml).<\/jats:p><jats:p>In our preliminary experience, the cortical bone trajectory pedicle screw technique seems to be a reasonable alternative to the traditional trajectory pedicle screw placement in children. Cortical screws seem to offer satisfactory clinical and radiographic outcomes, with a low complication profile.<\/jats:p>","DOI":"10.3171\/2017.7.peds17240","type":"journal-article","created":{"date-parts":[[2017,11,17]],"date-time":"2017-11-17T14:55:19Z","timestamp":1510930519000},"page":"190-196","source":"Crossref","is-referenced-by-count":6,"title":["Feasibility and safety of using thoracic and lumbar cortical bone trajectory pedicle screws in spinal constructs in children: technical note"],"prefix":"10.3171","volume":"21","author":[{"given":"Jonathan N.","family":"Sellin","sequence":"first","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Raskin","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristen A.","family":"Staggers","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Brayton","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Brice\u00f1o","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amee J.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Texas Children\u2019s Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Jea","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Riley Hospital for Children, Department of Neurosurgery, Indiana University School of Medicine, Goodman Campbell Brain and Spine, Indianapolis, Indiana"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"E335","DOI":"10.1097\/BRS.0000000000001233","article-title":"Fatigue performance of cortical bone trajectory screw compared with standard trajectory pedicle screw","volume":"41","author":"Akpolat YT","year":"2016","unstructured":"Akpolat YT, \u0130nceo\u011flu S, Kinne N, Hunt D, Cheng WK: Fatigue performance of cortical bone trajectory screw compared with standard trajectory pedicle screw. 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