Asian Spine J.  2016 Oct;10(5):950-954. 10.4184/asj.2016.10.5.950.

Challenges of Transarticular Screw Fixation in Young Children: Report of Surgical Treatment of a 5-Year-Old Patient's Unstable Os-Odontoideum

• Takahashi
• Hirabayashi H
• Hashidate
• Ogihara N
• Mukaiyama
• Komatsu M
• Inaba Y
• Kosho T
• Kato H

• KMID: 2354823
• DOI: http://doi.org/10.4184/asj.2016.10.5.950

Abstract

Surgical procedures for atlantoaxial (C1-C2) fusion in young children are relatively uncommon. The purpose of this study was to report on a surgical treatment for a case of atlantoaxial instability caused by os-odontoideum in association with quadriparesis and respiratory paralysis in a 5-year-old girl. We present the patient's history, physical examination, and radiographic findings, describe the surgical treatment and a five year follow-up, and provide a literature review. The instability was treated by halo immobilization, followed by C1-C2 transarticular screw fixation using a computed tomography-based navigation system. At the five year follow-up, the patient had made a complete recovery with solid union. The authors conclude that C1-2 transarticular screw fixation is technically possible as in a case of atlantoaxial instability in a five-year-old child.

Keyword

Atlantoaxial instability; Os-odontoideum; C1-C2 Transarticular screw fixation; CT-based navigation system; Young children

MeSH Terms

Child*
Child, Preschool*
Female
Follow-Up Studies
Humans
Immobilization
Physical Examination
Quadriplegia
Respiratory Paralysis