Related Experiment Videos
Non-traumatic atlanto-axial subluxation in an 8-year-old child
1Department of Neurosurgery, Mater Private Hospital, Dublin, Ireland.
Insights
A child with a retropharyngeal abscess developed quadriparesis due to atlanto-axial subluxation. Surgical removal of the odontoid peg and C2 body, followed by fusion, successfully treated the severe neural compression.
Area of Science:
- Pediatric Neurosurgery
- Spinal Surgery
- Cervical Spine Disorders
Background:
- Neonatal retropharyngeal abscess can lead to delayed complications.
- Atlanto-axial subluxation is a rare but serious spinal condition.
- Progressive quadriparesis in children necessitates urgent investigation.
Observation:
- An 8-year-old presented with a 6-month history of progressive quadriparesis.
- Imaging revealed atlanto-axial subluxation with anterior odontoid peg displacement.
- Severe neural compression at the C1-C2 level was confirmed by MRI.
Findings:
- Successful transoral removal of the odontoid peg and upper C2 body was performed.
- A subsequent posterior occipito-cervical fusion stabilized the cervical spine.
- Halo fixation was utilized for initial management and stabilization.
Implications:
- This case highlights the importance of recognizing delayed complications of neonatal infections.
- Surgical intervention, including odontoid peg removal and fusion, can effectively manage severe atlanto-axial subluxation.
- Multidisciplinary management is crucial for optimizing outcomes in pediatric cervical spine injuries.
Abstract:
An 8-year-old child with a previous history of neonatal retropharyngeal abscess presented with a 6-month history of progressive quadriparesis. Investigations demonstrated atlanto-axial subluxation with anterior displacement of the odontoid peg to a position anterior to the vertebral body of C2. Magnetic resonance imaging confirmed severe neural compression at this level. The child was placed in a halo fixation device and underwent transoral removal of the odontoid peg together with the upper part of the body of C2. At a subsequent procedure a posterior occipito-cervical fusion was performed. The aetiology and management of this case are discussed.