Long-term clinical and radiological postoperative outcomes after C1-C2 pedicle screw techniques for pediatric atlantoaxial rotatory dislocation.

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Long-term clinical and radiological postoperative outcomes after C1-C2 pedicle screw techniques for pediatric atlantoaxial rotatory dislocation.

World Neurosurg. 2018 Apr 17;:

Authors: Wu X, Li Y, Tan M, Yi P, Yang F, Tang X, Hao Q

Abstract
BACKGROUND: Although C1-C2 pedicle screw techniques have been extensively reported in paediatric series, reports on their use have examined only small series with short follow-up periods. Here, we present a study on paediatric patients with atlantoaxial rotatory dislocation (AARD) treated with these techniques with a minimum 5-year follow-up period.
METHODS: A total of 27 paediatric patients with AARD who underwent C1-C2 pedicle screw fixation between 2004 and 2012 were retrospectively evaluated. The clinical and radiographic outcomes were collected and compared with those of the control group.
RESULTS: The follow-up period ranged from 60 to 142 months (mean 84 months). Torticollis was completely corrected postoperatively in all but one patient. All patients experienced significant pain relief and improvement in range of motion (ROM), and 6 patients with neurological deficits experienced significant improvement postoperatively. Both the atlantodental interval (ADI) and the space available for the cord (SAC) were significantly improved compared to the preoperative values. Regarding the cervical curvature, lordosis was observed in 20 cases, and straight in 7 cases at the final follow-up. Compared to the control group, the ROM of the patient group was not significantly different any direction except in flexion and rotation. The mean anterior-posterior (AP) diameters of the spinal canal at the C1 and C2 levels were not significantly different from those of the control group.
CONCLUSION: C1-C2 pedicle screw techniques are relatively safe and effective for the treatment of AARD and result in no obvious limitation on growth in relatively older children.

PMID: 29678707 [PubMed - as supplied by publisher]

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