Anterior Exposures of the Pediatric Spine and Posterior Pedicle Screw Instrumentation

Treatment of spinal deformities, tumors, and trauma is greatly facilitated by correctly understanding the associated anatomy. Exposure of the spine, whether with a standard posterior dissection or a technically demanding costotransversectomy, facilitates surgical treatment of all disorders. When indicated, posterior instrumentation with pedicle screws allows for maximum rigidity and stability until arthrodesis ensues. Appropriate stepwise screw placement and confirmation of placement with radiographs and triggered electromyograms allows safe use of pedicle screws at all regions of the spine, with no associated morbidity to the patient. This article focuses on the classic approaches used to access the pediatric spine and discusses modern-day pedicle screw instrumentation for spinal pediatric deformity, trauma, or tumors.