A new occipitocervical fusion construct in pediatric patients with occipitocervical instability. Technical note

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Pediatric Spine Surgery

Background:

• Occipitocervical instability presents significant challenges in pediatric patients.
• Traditional stabilization methods may involve external bracing, impacting patient comfort and compliance.

Purpose of the Study:

• To evaluate the efficacy and safety of posterior occipitocervical stabilization using C1-2 transarticular screws and a rigid construct in pediatric patients.
• To assess fusion rates and implant survival without the need for external orthotic devices.

Main Methods:

• Posterior occipitocervical stabilization was performed in 10 pediatric patients (age ≤16 years).
• The surgical technique involved C1-2 transarticular screws coupled with a rigid occipitocervical construct.
• Follow-up evaluation averaged 18.8 months (range 5-37 months).

Main Results:

• All 10 patients (nine boys, one girl) achieved successful fusion.
• No implant failures were reported in any of the patients.
• External orthotic halo devices were not required for any patient.

Conclusions:

• C1-2 transarticular screws combined with a rigid occipitocervical construct provide a safe and effective method for posterior stabilization in pediatric patients.
• This surgical approach facilitates successful fusion without the need for postoperative external bracing.
• The technique demonstrates promising outcomes for managing occipitocervical instability in young individuals.