Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years
Purpose: This study aimed to investigate radiographic outcomes after posterior spinal fusion (PSF) for pediatric patients younger than 10 years with upper cervical disorders. Methods: Thirteen patients (mean age at surgery, 5.9 years; range, 1 to 9 years) who underwent PSF with a minimum of 2 years...
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2017-01-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/1/1/1_1.2016-0013/_pdf/-char/en |
| _version_ | 1828850702958460928 |
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| author | Kei Watanabe Toru Hirano Keiichi Katsumi Masayuki Ohashi Hirokazu Shoji Kazuhiro Hasegawa Takui Ito Naoto Endo |
| author_facet | Kei Watanabe Toru Hirano Keiichi Katsumi Masayuki Ohashi Hirokazu Shoji Kazuhiro Hasegawa Takui Ito Naoto Endo |
| author_sort | Kei Watanabe |
| collection | DOAJ |
| description | Purpose: This study aimed to investigate radiographic outcomes after posterior spinal fusion (PSF) for pediatric patients younger than 10 years with upper cervical disorders. Methods: Thirteen patients (mean age at surgery, 5.9 years; range, 1 to 9 years) who underwent PSF with a minimum of 2 years of follow-up (mean, 5.8 years) were included. Diagnoses were atlanto-axial instability due to congenital disorders for 11 patients and atlanto-axial rotatory fixation for 2 patients. The fusion area was occipito-cervical for 7 patients and C1/2 for 6 patients. PSF was performed using rigid screw-rod constructs for 6 patients and conventional techniques for 7 patients. Ten patients required halo immobilization after surgery. Fusion status, perioperative complications, radiographic alignment, and range of motion (ROM) from C2 to C7 were evaluated. Results: Twelve patients successfully achieved bony fusion (fusion rate, 92%), but complications occurred in 5 patients. Regarding radiographic measures (preoperative/postoperative/final follow-up), the mean atlanto-dental interval was significantly reduced (8.0 mm/2.7 mm/3.5 mm) and the C2-7 ROM was increased (from 49.4 degrees to 66.0 degrees) at the final follow-up (both comparisons, p<0.05). Sagittal alignment was unchanged. Conclusion: Use of rigid screw-rod instrumentation in the upper cervical spine with careful radiological evaluation is amenable for pediatric patients younger than 10 years. However, conventional procedures such as wiring fixation with rigid external immobilization are still alternative options for preventing serious neurological and vascular complications. |
| first_indexed | 2024-12-12T23:17:32Z |
| format | Article |
| id | doaj.art-eb51fc7088214fe0bc74e649e095f8d3 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-12-12T23:17:32Z |
| publishDate | 2017-01-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-eb51fc7088214fe0bc74e649e095f8d32022-12-22T00:08:24ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2017-01-0111141910.22603/ssrr.1.2016-00131.2016-0013Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 YearsKei Watanabe0Toru Hirano1Keiichi Katsumi2Masayuki Ohashi3Hirokazu Shoji4Kazuhiro Hasegawa5Takui Ito6Naoto Endo7Department of Orthopedic Surgery, Niigata University Medical and Dental General HospitalDepartment of Orthopedic Surgery, Niigata University Medical and Dental General HospitalDepartment of Orthopedic Surgery, Niigata University Medical and Dental General HospitalDepartment of Orthopedic Surgery, Niigata University Medical and Dental General HospitalDepartment of Orthopedic Surgery, Niigata University Medical and Dental General HospitalNiigata Spine Surgery CenterDepartment of Orthopedic Surgery, Niigata City General HospitalDepartment of Orthopedic Surgery, Niigata University Medical and Dental General HospitalPurpose: This study aimed to investigate radiographic outcomes after posterior spinal fusion (PSF) for pediatric patients younger than 10 years with upper cervical disorders. Methods: Thirteen patients (mean age at surgery, 5.9 years; range, 1 to 9 years) who underwent PSF with a minimum of 2 years of follow-up (mean, 5.8 years) were included. Diagnoses were atlanto-axial instability due to congenital disorders for 11 patients and atlanto-axial rotatory fixation for 2 patients. The fusion area was occipito-cervical for 7 patients and C1/2 for 6 patients. PSF was performed using rigid screw-rod constructs for 6 patients and conventional techniques for 7 patients. Ten patients required halo immobilization after surgery. Fusion status, perioperative complications, radiographic alignment, and range of motion (ROM) from C2 to C7 were evaluated. Results: Twelve patients successfully achieved bony fusion (fusion rate, 92%), but complications occurred in 5 patients. Regarding radiographic measures (preoperative/postoperative/final follow-up), the mean atlanto-dental interval was significantly reduced (8.0 mm/2.7 mm/3.5 mm) and the C2-7 ROM was increased (from 49.4 degrees to 66.0 degrees) at the final follow-up (both comparisons, p<0.05). Sagittal alignment was unchanged. Conclusion: Use of rigid screw-rod instrumentation in the upper cervical spine with careful radiological evaluation is amenable for pediatric patients younger than 10 years. However, conventional procedures such as wiring fixation with rigid external immobilization are still alternative options for preventing serious neurological and vascular complications.https://www.jstage.jst.go.jp/article/ssrr/1/1/1_1.2016-0013/_pdf/-char/enpediatric patientatlanto-axial instabilityatlanto-axial rotatory fixationposterior fusionupper cervical spine |
| spellingShingle | Kei Watanabe Toru Hirano Keiichi Katsumi Masayuki Ohashi Hirokazu Shoji Kazuhiro Hasegawa Takui Ito Naoto Endo Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years Spine Surgery and Related Research pediatric patient atlanto-axial instability atlanto-axial rotatory fixation posterior fusion upper cervical spine |
| title | Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years |
| title_full | Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years |
| title_fullStr | Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years |
| title_full_unstemmed | Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years |
| title_short | Radiographic Outcomes of Upper Cervical Fusion for Pediatric Patients Younger Than 10 Years |
| title_sort | radiographic outcomes of upper cervical fusion for pediatric patients younger than 10 years |
| topic | pediatric patient atlanto-axial instability atlanto-axial rotatory fixation posterior fusion upper cervical spine |
| url | https://www.jstage.jst.go.jp/article/ssrr/1/1/1_1.2016-0013/_pdf/-char/en |
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