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Evaluation of Alternative Halo Ring Positions in Children Using Tomography
OBJECTIVES: The halo ring can be applied in children, through skeletal traction or a halo vest device, to treat many cervical spine pathologies, including traumatic injuries and pathologies related to deformities. However, the procedure is associated with various complications, such as infection, pi...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399660/ https://www.ncbi.nlm.nih.gov/pubmed/30892417 http://dx.doi.org/10.6061/clinics/2019/e781 |
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author | Tavares-Júnior, Mauro Costa Morais Munhoz, Diego Ubrig de Souza, João Paço Vaz Marcon, Raphael Martus Cristante, Alexandre Fogaça Letaif, Olavo Biraghi |
author_facet | Tavares-Júnior, Mauro Costa Morais Munhoz, Diego Ubrig de Souza, João Paço Vaz Marcon, Raphael Martus Cristante, Alexandre Fogaça Letaif, Olavo Biraghi |
author_sort | Tavares-Júnior, Mauro Costa Morais |
collection | PubMed |
description | OBJECTIVES: The halo ring can be applied in children, through skeletal traction or a halo vest device, to treat many cervical spine pathologies, including traumatic injuries and pathologies related to deformities. However, the procedure is associated with various complications, such as infection, pin loosening, and respiratory and neurological problems. Although widely studied in adults, the best pin insertion site in children and the correlations of pin insertion sites with outcomes and complications have not been completely elucidated. This study aimed to determine alternative pin placement sites based on a morphological analysis of the infant skull by computerized tomography (CT). METHODS: An analytical-descriptive study was performed using 50 CT scans from children. The Wilcoxon and Friedman tests were used. RESULTS: A linear and directly proportional relation was found between cranial thickness and patient age. The average thicknesses of the anterior points across all ages analyzed ranged from 4.16 mm to 4.98 mm. The thicknesses of the posterior points varied from 3.94 mm to 4.27 mm. Within each age range, points 1 cm above the standard insertion sites had thicknesses similar to those of the standard sites, and points 2 cm above the standard insertion sites had thicknesses greater than those of the standard sites. CONCLUSIONS: The cranial thickness at all points increases linearly with age. Points 1 and 2 cm above the standard insertion sites are viable alternatives for the placement of halo pins. Preoperative CT can aid in choosing the best positioning sites for pins in the skull. |
format | Online Article Text |
id | pubmed-6399660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-63996602019-03-07 Evaluation of Alternative Halo Ring Positions in Children Using Tomography Tavares-Júnior, Mauro Costa Morais Munhoz, Diego Ubrig de Souza, João Paço Vaz Marcon, Raphael Martus Cristante, Alexandre Fogaça Letaif, Olavo Biraghi Clinics (Sao Paulo) Original Article OBJECTIVES: The halo ring can be applied in children, through skeletal traction or a halo vest device, to treat many cervical spine pathologies, including traumatic injuries and pathologies related to deformities. However, the procedure is associated with various complications, such as infection, pin loosening, and respiratory and neurological problems. Although widely studied in adults, the best pin insertion site in children and the correlations of pin insertion sites with outcomes and complications have not been completely elucidated. This study aimed to determine alternative pin placement sites based on a morphological analysis of the infant skull by computerized tomography (CT). METHODS: An analytical-descriptive study was performed using 50 CT scans from children. The Wilcoxon and Friedman tests were used. RESULTS: A linear and directly proportional relation was found between cranial thickness and patient age. The average thicknesses of the anterior points across all ages analyzed ranged from 4.16 mm to 4.98 mm. The thicknesses of the posterior points varied from 3.94 mm to 4.27 mm. Within each age range, points 1 cm above the standard insertion sites had thicknesses similar to those of the standard sites, and points 2 cm above the standard insertion sites had thicknesses greater than those of the standard sites. CONCLUSIONS: The cranial thickness at all points increases linearly with age. Points 1 and 2 cm above the standard insertion sites are viable alternatives for the placement of halo pins. Preoperative CT can aid in choosing the best positioning sites for pins in the skull. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2019-03-05 2019 /pmc/articles/PMC6399660/ /pubmed/30892417 http://dx.doi.org/10.6061/clinics/2019/e781 Text en Copyright © 2019 CLINICS http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited. |
spellingShingle | Original Article Tavares-Júnior, Mauro Costa Morais Munhoz, Diego Ubrig de Souza, João Paço Vaz Marcon, Raphael Martus Cristante, Alexandre Fogaça Letaif, Olavo Biraghi Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title | Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title_full | Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title_fullStr | Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title_full_unstemmed | Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title_short | Evaluation of Alternative Halo Ring Positions in Children Using Tomography |
title_sort | evaluation of alternative halo ring positions in children using tomography |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6399660/ https://www.ncbi.nlm.nih.gov/pubmed/30892417 http://dx.doi.org/10.6061/clinics/2019/e781 |
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