Long-term growth and alignment after occipitocervical and atlantoaxial fusion with rigid internal fixation in young children.

摘要: OBJECT The long-term consequences of atlantoaxial (AA) and occipitocervical (OC) fusion instrumentation in young children are unknown. Anecdotal reports have raised concerns regarding altered growth alignment the cervical spine after surgical intervention. purpose this study was to determine effects these surgeries on maturing spine. METHODS A multiinstitutional retrospective chart review conducted for patients less than or equal 6 years age who underwent OC AA with rigid at 9 participating centers. All had least 3 clinical radiographic follow-up data radiographically confirmed fusion. Preoperative, immediate postoperative, most recent radiographs and/or CT scans were evaluated assess changes spinal alignment. RESULTS Forty (9 31 fusion) included (mean duration 56 months). mean vertical over fused levels represented 30% (range 10%-50%). Three different patterns construct developed among during period: 1) 16 substantial (13%-46% total spine); 2) no meaningful growth; 3) patients, whom presented a distracted atlantooccipital dislocation, decrease height 7-23 mm). Regarding alignment, 85% (34/40) good follow-up, straight mildly lordotic curvatures. In 1 patient (11%) 5 (16%), we observed new hyperlordosis 43°-62°). There cases kyphosis swan-neck deformity, evidence subaxial instability, unintended No preoperative predictors evident. CONCLUSIONS These results demonstrate that undergoing internal fixation continue continued within prolonged period. However, some variability exists, highlighting need close follow-up.