The surgical treatment of instability of the upper part of the cervical spine in children and adolescents.

摘要: In a retrospective review of the cases thirteen skeletally immature children and adolescents (four to eighteen years old) with instability upper part cervical spine (occiput fifth vertebra), we determined efficacy posterior arthrodesis halo-cast immobilization in management this condition. The patients were divided into two groups: those congenital vertebral anomalies alone (fusion or structural defects, both) systemic disorders (dwarfism, juvenile rheumatoid arthritis, Down syndrome, cerebral palsy). Two patterns found: instabilities at intervertebral joints adjacent fusions, located defects. For all treatment included external by halo cast, internal fixation wire was also used. Solid obtained twelve who treated autogenous grafts (iliac cancellous bone eleven rib one), non-union developed child bank-bone segments. Posterior carries some risk neural injury often is not applicable anomalous vertebrae. Spine fusion using delicate exposure, decortication an air-drill, placement iliac cast minimizes damage reliable way obtain solid arthrodesis.