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C1-C2 Distraction Ligamentous Injury Treated with Halo-Vest Application: A Case Report
Stephen R Stephan1, Lindsay M Andras2, David L Skaggs2
1Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Case:
There is a paucity of literature regarding pediatric upper cervical spine traumatic instability, atlanto-occipital dislocations, and fractures, with no clear treatment algorithm. We present a 12-year-old girl with significant posterior C1-C2 distraction and resultant ligamentous injury after a motor vehicle collision who was treated with a halo vest for 3 months. At 8-month follow-up, follow-up magnetic resonance imaging demonstrated complete ligamentous healing without instability on dynamic radiographs, and at 18-month follow-up, the patient made a full recovery.
Conclusion:
In some pediatric patients with isolated posterior ligamentous injury, as long as anatomic alignment can be achieved with halo-vest application, a fusion may be avoided.
