Surgery for upper cervical spine instabilities in children

Area of Science:

• Pediatric Orthopedics
• Neurosurgery
• Spinal Surgery

Background:

• Limited data exists on surgical fusion for pediatric upper cervical spine instabilities.
• This study contributes findings from a series of pediatric cases.

Purpose of the Study:

• To report the outcomes of surgical fusion for upper cervical spine instabilities in children.
• To provide additional data to the existing literature.

Main Methods:

• Eleven children (3-16 years) underwent 13 surgical procedures for various instabilities.
• Techniques included transoral odontectomies, screw-fixations, wiring, and iliac crest bone grafting.
• Outcomes assessed via pain scores, neurological status, and radiological imaging over a mean follow-up of 25.4 months.

Main Results:

• All patients achieved stable fusion.
• Neurological status improved or remained stable in all patients.
• Pain scores improved in 9 out of 11 patients, with 3 peri-operative complications noted.

Conclusions:

• Modern screw fixation techniques and treatment algorithms used in adults are applicable to older children with upper cervical spine instabilities.
• Treatment for children younger than 6 years and those with congenital instabilities requires individualized approaches.