Management of Pediatric Congenital Atlantoaxial Dislocation: A Report of 23 Cases from Northern India

摘要: From July 1996 to August 2001, we operated on 23 children (age 4-12 years) with congenital atlantoaxial dislocation (AAD). Sixteen had reducible AAD and 6 the fixed type, while a single patient basilar invagination. Preoperatively, these were divided into four functional grades depending level of neurological deficits dependence others for activities daily living (Di Lorenzo I-IV). There only 2 patients no (grade I), 15 presented severe completely dependent all IV). Stigmata suggestive documented in radiological osseous anomalies 18 children. Transoral decompression posterior stabilization was performed 7 children, 16 underwent procedure only. All immobilized hard cervical collar postoperatively. Six developed one or other treatable complications, whom reoperation indicated 3, but could be undertaken Retightening wire done 1 further odontoid process carried out other. postoperative deterioration preoperative I). Ten who period IV) improved, achieved normalcy near I II). Three deteriorated period, subsequently improved at follow-up. deaths series; both belonged severely compromised group addition respiratory compromise. Bony fusion site seen 14 screened. The various problems faced by authors managing very fragile cervicomedullary compression due setting limited resources are discussed.