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Spontaneous bone graft resorption in os odontoideum
1Westmead Hospital, New South Wales, Australia.
The Australian and New Zealand Journal of Surgery
|June 1, 1992
Summary
Spinal fusion in children with os odontoideum can recur due to bone graft resorption. This rare complication requires careful patient monitoring after upper cervical spine surgery.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurosurgery
- Spinal Fusion
Background:
- Os odontoideum is a rare condition causing instability in the upper cervical spine.
- Posterior spinal fusion is a surgical option to address this instability.
- Bone graft resorption is a known, though infrequent, complication after spinal fusion.
Observation:
- Two pediatric cases of posterior upper cervical spine fusion for os odontoideum were reviewed.
- Radiographic evidence of successful fusion was initially observed in both patients.
- Both patients later developed recurrent instability.
Findings:
- Spontaneous bone graft resorption was identified as the cause of recurrent instability.
- This phenomenon, leading to failure of the posterior fusion, is rarely reported.
- The rate of graft resorption and subsequent instability recurrence was 100% in this small cohort.
Implications:
- Awareness of spontaneous bone graft resorption is crucial for managing os odontoideum.
- Pre-operative patient counseling should include the risk of graft resorption and potential recurrence.
- Postoperative follow-up protocols need to incorporate monitoring for signs of instability after fusion.