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Internal stabilization of a flexion-distraction injury of the upper cervical spine of a toddler: a new technique and literature review

STUDY DESIGN: A case report and literature review. OBJECTIVE: To present a new and simple technique of fixation without fusion of a rare unstable Salter-Harris type I injury in the upper cervical spine of a 23-month-old toddler. SUMMARY OF BACKGROUND DATA: Surgical treatment of unstable pediatric cervical spine injuries most commonly involves posterior fusion with internal fixation, usually posterior wiring. METHODS: Detailed description of the surgical procedure carried out for fixating an unstable flexion-distraction injury in a 23-month-old toddler, with severe head injury and pneumothorax, is presented. RESULTS: A rare unstable flexion-distraction injury in the upper cervical spine of a toddler was successfully treated with a posterior Number 2 Vicryl (polyglactin 910; ETHICON Division of Johnson & Johnson) suture fixation, with good healing of the ligaments and end plates, without fusion. Preservation of motion was achieved without obvious instability at 28 months postsurgery. CONCLUSION: In selected cases of cervical spine injuries in the young pediatric population, simple stabilization of the spine using degradable Number 2 Vicryl (polyglactin 910) sutures with minimal exposure can provide sufficient stability until healing occurs. Advantages are that fusion is avoided and motion preserved

Keywords : Cervical Vertebrae,Head,Humans,Infant,injuries,Ligaments,Male,methods,Motion,Pneumothorax,Polyglactin 910,Spinal Injuries,Spine,surgery,Sutures,therapeutic use,Treatment Outcome,, Stabilization,Flexiondistraction,Injury, nurse counsellor

Date of Publication : 2012 Mar 15

Authors : Hamoud K;Hershkovitz I;Hanani A;Marom L;Abbas J;

Organisation : Spine Unit, Rambam Health Care Campus, Haifa, Israel. k_hamoud@yahoo.com

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21857398

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