Related Experiment Video
Updated: Apr 25, 2026
A Contusive Model of Unilateral Cervical Spinal Cord Injury Using the Infinite Horizon Impactor
Published on: July 24, 2012
Highly unstable cervical spine injury in an infant: a case report
Sue young Ha1, Sun-Ho Lee, Eun-Sang Kim
1Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University, School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul, 135-710, South Korea.
Insights
A novel suturing technique using Ethibond sutures provides effective internal fixation for unstable pediatric cervical spine injuries in infants. This method offers a safe alternative to traditional instrumentation for young children.
Area of Science:
- Orthopedic Surgery
- Pediatric Spine Surgery
- Cervical Spine Injury Management
Background:
- Pediatric cervical spine injuries are increasingly managed surgically, but existing instrumentation techniques are not suitable for infants.
- Infants' cartilaginous bone and poor bone strength pose significant risks with traditional wires or cables.
- There is a need for safe and effective stabilization methods for cervical injuries in children under one year of age.
Observation:
- A 5-month-old infant presented with a severe C6-C7 distraction injury and bilateral facet joint disruption.
- The infant was initially managed with a custom occipito-cervical brace.
- Surgical stabilization involved internal fixation using a nonabsorbable synthetic suture (Ethibond).
Findings:
- The technique involved passing Ethibond suture through the superior articular process of C6 to the facet joint and into the spinous process of the lower level.
- Progressive tightening of the suture achieved anatomical reduction.
- Post-surgery, solid fusion was achieved, and the infant could sit independently within 6 months.
Implications:
- This suture-based internal fixation technique offers a viable alternative for treating unstable cervical spine injuries in infants.
- It demonstrates the potential for successful non-fusion stabilization in this vulnerable population.
- Further research may validate this approach for broader application in pediatric spine surgery.
Unlabelled:
Although the rate of surgical intervention for pediatric cervical spine injuries has risen, none of these instrumentation techniques has been reported in children less than 1 year of age. Additional consideration with placement of wires or cables is not safe because of the presence of cartilaginous bone and poor bone strength. The authors report a technique of internal fixation without fusion using nonabsorbable synthetic suture in an infant with unstable cervical injury.
Methods:
A 5-month-old girl was transported to emergency department and computed tomography showed severe distraction injury at the C6-7 level with total disruption of the facet joints bilaterally. To improve her general condition, she was placed in a customized occipito-cervical brace until surgical stabilization could be performed. After 1 month, surgical fixation was performed. After removing all soft tissues at the appropriate level, a hole was made in the center of the superior articular process of C6. A nonabsorbable suture (2-0 Ethibond; Ethicon, Somerville, NJ, USA) was passed from the superior articular process to the facet joint. The suture was passed into the spinous process of the lower level, and it was progressively tightened and radiographs were taken until anatomic reduction was achieved.
Results:
After surgery, solid fusion was achieved. She was able to sit up in a stroller after 6 months.
Conclusion:
As surgical treatment of pediatric cervical spine injuries is unsuitable for infants, the Ethibond sutures are strong enough to hold and stabilize the spine. This suturing technique can be used as an alternative treatment for cervical injury in infants.
