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Upper cervical spine fusion in the pediatric population
D W Lowry1, I F Pollack, B Clyde
1Department of Neurological Surgery, University of Pittsburgh, Children's Hospital of Pittsburgh, Pennsylvania 15213, USA.
Journal of Neurosurgery
|November 5, 1997
Summary
Posterior upper cervical fusion is a highly successful surgical treatment for pediatric spinal instability. This study of 25 children shows significant neurological improvement and high fusion rates with careful surgical management.
Area of Science:
- Orthopedic Surgery
- Pediatric Neurosurgery
- Spinal Fusion
Background:
- Pediatric spinal instability requires effective surgical intervention.
- Upper cervical and occipitocervical fusions are complex procedures in children.
- Understanding outcomes is crucial for optimizing treatment strategies.
Purpose of the Study:
- To review the outcomes of pediatric patients undergoing posterior upper cervical or occipitocervical fusion.
- To evaluate the success rates and complications associated with these procedures.
- To identify factors that may improve surgical results in pediatric spinal fusion.
Main Methods:
- Retrospective review of 25 pediatric patients undergoing upper cervical/occipitocervical fusion.
- Analysis of presenting conditions including os odontoideum, atlantoaxial instability, and others.
- Assessment of neurological status, fusion rates, and complications.
Main Results:
- High fusion success rate (21/25 initially, all but one eventually).
- Significant neurological improvement in 9 out of 10 patients with preoperative deficits.
- Complications included cable erosion, pin site infection, and hardware slippage.
Conclusions:
- Posterior upper cervical fusion is highly successful in the pediatric population.
- Appropriate surgical management leads to good outcomes and neurological recovery.
- Attention to halo pin site care and judicious use of cabling material can enhance results.