Challenges of Transarticular Screw Fixation in Young Children: Report of Surgical Treatment of a 5-Year-Old Patient's Unstable Os-Odontoideum.
10.4184/asj.2016.10.5.950
- Author:
Jun TAKAHASHI
1
;
Hiroki HIRABAYASHI
;
Hiroyuki HASHIDATE
;
Nobuhide OGIHARA
;
Keijiro MUKAIYAMA
;
Masatoshi KOMATSU
;
Yuji INABA
;
Tomoki KOSHO
;
Hiroyuki KATO
Author Information
1. Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan. jtaka@shinshu-u.ac.jp
- Publication Type:Case Report
- Keywords:
Atlantoaxial instability;
Os-odontoideum;
C1-C2 Transarticular screw fixation;
CT-based navigation system;
Young children
- MeSH:
Child*;
Child, Preschool*;
Female;
Follow-Up Studies;
Humans;
Immobilization;
Physical Examination;
Quadriplegia;
Respiratory Paralysis
- From:Asian Spine Journal
2016;10(5):950-954
- CountryRepublic of Korea
- Language:English
-
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.
