Pinning in pediatric neurosurgery: the modified rubber stopper technique

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  • 1 Department of Neurosurgery, Baylor College of Medicine, Houston;
  • 2 Division of Pediatric Neurosurgery, Texas Children’s Hospital, Houston, Texas;
  • 3 Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago; and
  • 4 Division of Pediatric Neurosurgery, Ann and Robert H. Lurie Children’s Hospital, Chicago, Illinois
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Head immobilization devices with skull pins are commonly used by neurosurgeons to stabilize the head for microsurgical techniques and to maintain accurate intraoperative neuronavigation. Pediatric patients, who may have open fontanelles, unfused sutures, and thin skulls, are vulnerable to complications during placement in pins. We review the various methods of pinning in pediatric neurosurgery and revisit the modified rubber stopper technique using a commonly available rubber stopper from a medication bottle over a standard adult pin of a Mayfield head clamp to prevent the pins from plunging through the thin pediatric skull.

ABBREVIATIONS HID = head immobilization device.

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Contributor Notes

Correspondence Sandi K. Lam: Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL. sandilam@gmail.com; slam@luriechildrens.org.

INCLUDE WHEN CITING Published online April 10, 2020; DOI: 10.3171/2020.1.PEDS19541.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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