Atlanto-Occipital Transarticular Screw Fixation for the Treatment of Traumatic Occipitocervical Instability in the Pediatric Population

Hassler, Kenneth R.; Jamshidi, Ramin; Vail, Sydney J.; Connell, Mary J.; Chundu, Kote; Lettieri, Salvatore C.; Feiz-Erfan, Iman

doi:10.1016/j.wneu.2020.04.129

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…We identified eight studies, five of them favoring primary therapy with HF [ 37 , 39 , 42 , 46 , 47 ]. Takahashi et al [ 43 ] used HF prior to surgery and other authors used it after surgery [ 18 , 30 ]. The principal purpose of HF therapy for traumatic C2 fracture with instability is fusion or bone healing [ 39 , 42 , 46 , 47 ].…”

Section: Resultsmentioning

confidence: 99%

“…A hangman’s fracture is a hyperextension C2 injury with upper cervical spine fracture, which is almost exclusively seen in children under the age of two. The incidence increases again from the age of 16, where it has the same characteristics as C2 fractures in adults [ 18 , 30 , 38 , 42 ]. The recommended treatment for a hangman’s fracture varies according to the type and severity of the fracture instability [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…HF is in widespread use to treat a variety of disorders and pathologies in children and adults [ 4 , 7 , 25 , 33 , 51 ]. The main indications for HF range from pre-surgical correction [ 8 , 19 , 28 , 43 ] to postoperative fusion support [ 18 , 21 ]. Used as an alternative to surgical treatment, HF enables the treating physician to preserve neck mobility and avoid side effects, such as restricted neck mobility and interference with spinal growth potential [ 8 , 9 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Use of halo fixation therapy for traumatic cranio-cervical instability in children: a systematic review

Banat

Vychopen

Wach

et al. 2021

Eur J Trauma Emerg Surg

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Purpose Traumatic cranio-cervical instability in childhood is rare and constitutes a challenge for the treating surgeon. The aim of therapy is to restore cervical stability without limiting the range of motion. The goal of this systematic review was to find out whether, over the last 10 years, halo fixation (HF) could still be considered a successful treatment option without major risks or complications. Methods We analyzed studies describing the use of HF in traumatic injuries of the cranio-cervical junction in children under the age of 17. Searches were performed in PubMed, MEDLINE and Embase databases for the years from 2010 to 2020. The general success rate, the success rate related to underlying pathologies, and complication rates were evaluated. Results The main indications for HF range from pre-surgical correction to postoperative fusion support. C2 is the most frequently injured vertebra in children. The overall success rate of HF was very high. Evaluation according to the underlying pathology showed that, except for atlanto-occipital dislocation, HF generates high fusion rates among different patient cohorts, mainly in C2 vertebra injuries and atlantoaxial rotatory subluxation. Only minor complications were reported, such as pin infections. Conclusion The current data show that, when used according to the appropriate indication, HF is an effective conservative treatment option for cranio-cervical instability, associated with only minor complications.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of halo fixation therapy for traumatic cranio-cervical instability in children: a systematic review

Banat

Vychopen

Wach

et al. 2021

Eur J Trauma Emerg Surg

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“…Although the indications for internal fixation in children are similar to those for adults, the data concerning techniques, complications, and outcomes of spinal instrumentation are mainly derived from either congenital anomalies or pediatric trauma cases in previous retrospective series. [12][13][14][15] DecisionmakingaroundOCFinthecontextoftumorsurgery, such asin chordoma of theskull base, isnot well establishedin children at this time.…”

Section: Discussionmentioning

confidence: 99%

Management of pediatric clival chordoma with extension to the craniocervical junction and occipito-cervical fusion: illustrative case

Liu

Gendreau

Loya

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND Chordomas are rare malignant neoplasms that develop from the primitive notochord with < 5% of the tumors occurring in pediatric patients younger than the age of 20. Of these pediatric chordomas, those affecting the craniocervical junction (C1–C2) are even more rare; therefore, parameters for surgical management of these pediatric tumors are not well characterized. OBSERVATIONS In this case, a 3-year-old male was found to have a clival chordoma on imaging with extension to the craniocervical junction resulting in spinal cord compression. Endoscopic-assisted transoral transclival approach for clival tumor resection was performed first. As a second stage, the patient underwent a left-sided far lateral craniotomy and cervical laminectomy for resection of the skull base chordoma and instrumented fusion of the occiput to C3. He made excellent improvements in strength and dexterity during rehab and was discharged after 3 weeks. LESSONS In pediatric patients with chordoma with extension to the craniocervical junction and spinal cord compression, decompression with additional occipito-cervical fusion appears to offer a good clinical outcome. Fusion performed as a separate surgery before or at the same time as the initial tumor resection surgery may lead to better outcomes.

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The Comparison Between Transarticular Screw Fixation and Segmental Screw-Rod Fixation for Posterior Fusion of the C1-2 Segment: A Systematic Review and Meta-Analysis

et al. 2022

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Atlanto-Occipital Transarticular Screw Fixation for the Treatment of Traumatic Occipitocervical Instability in the Pediatric Population

Cited by 4 publications

References 39 publications

Use of halo fixation therapy for traumatic cranio-cervical instability in children: a systematic review

Use of halo fixation therapy for traumatic cranio-cervical instability in children: a systematic review

Management of pediatric clival chordoma with extension to the craniocervical junction and occipito-cervical fusion: illustrative case

The Comparison Between Transarticular Screw Fixation and Segmental Screw-Rod Fixation for Posterior Fusion of the C1-2 Segment: A Systematic Review and Meta-Analysis

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