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[Hemi-atlas: report of five cases]
C D Giménez1, P Manzone, D Forlino
1Servicio de Neurología, Hospital de Pediatría Juan Pablo II. Corrientes. Argentina.
Neurocirugia (Asturias, Spain)
|July 23, 2003
Summary
Congenital C1 partial aplasia can cause severe torticollis in children. Surgical fusion (arthrodesis) of the upper cervical spine (C1-C3) with external immobilization effectively corrects this deformity.
Area of Science:
- Pediatric Orthopedics
- Neurosurgery
- Congenital Deformities
Background:
- Congenital C1 partial aplasia is a rare condition.
- It can lead to severe, progressive torticollis in children.
- This deformity affects the upper cervical spine, impacting neck alignment.
Observation:
- Five pediatric cases of C1 partial aplasia were treated.
- Four patients had defects in Villa's Area 3 (articular mass).
- One patient had a posterior hemi-arch defect (Area 2).
Findings:
- Surgical intervention included posterior occipito-cervical arthrodesis (C1-C3) with or without suboccipital decompression.
- Internal fixation used sutures or wire.
- Postoperative management involved Halo-vest and Philadelphia collar immobilization.
- All surgically treated patients showed deformity correction and successful arthrodesis.
- Non-operated patients improved with conservative therapy.
Implications:
- C1 partial aplasia with unyielding torticollis can be effectively managed surgically.
- Occipito-cervical (C1-C3) arthrodesis is a viable treatment option.
- Combined surgical and external immobilization strategies yield positive outcomes.