C1-C2 Pedicle Screw Fixation for Atlantoaxial Dislocation in Pediatric Sufferers Youthful than 5 Years: A Case Sequence of 15 Sufferers.
World Neurosurg. 2017 Dec;108:498-505
Authors: Zhang YH, Shao J, Chou D, Wu JF, Music J, Zhang J
OBJECTIVE: C1-C2 pedicle screw fixation has turn into standard for offering glorious bony buy and avoiding neurovascular issues. Nonetheless, it could be technically difficult in kids. The target of this examine is to analyze the protection and efficacy of C1-C2 pedicle screw fixation for atlantoaxial dislocation (AAD) in pediatric sufferers youthful than 5 years and to guage the preliminary scientific and radiographic outcomes.
METHODS: Throughout a 7-year interval, 15 sufferers with a imply age of three.four years (vary, 2-5 years) underwent C1-C2 pedicle screw fixation for AAD; no less than 1 C1 pedicle screw was integrated as a part of the posterior atlantoaxial fusion assemble. The trigger, surgical method, instrumentation, and scientific and radiographic outcomes had been analyzed.
RESULTS: 5 sufferers had preoperative neurologic deficits and no neurovascular harm occurred throughout surgical procedure. Anterior launch utilizing a retropharyngeal method was carried out in four circumstances. Fixation of 55 C1 and C2 pedicle screws was carried out efficiently with out neurovascular issues. Anatomic and partial reductions occurred in 12 and three circumstances, respectively. Stable fusion was achieved in 14 sufferers (96.9%) throughout a imply follow-up of 37.6 months (vary, 12-111 months). Two sufferers (13%) skilled issues: one had extended immobilization for a unfastened C1 pedicle screw, and one had unintended fusion attributable to allograft absorption. All sufferers confirmed radiographic stability and symptom decision.
CONCLUSIONS: C1-C2 pedicle screw fixation for AAD is protected and efficient even in kids youthful than 5 years.
PMID: 28927914 [PubMed – indexed for MEDLINE]