OBJECT: Rigid occipitocervical instrumentation for craniovertebral instability is gaining widespread acceptance for use in pediatric patients; however, most of the instrumentation has been modified from adult-sized hardware. The Wasatch loop system (formerly the Avery-Brockmeyer-Thiokol loop system) is a rigid occipitocervical fixation device designed specifically for use in children. It affixes to the occiput and incorporates either C1-2 transarticular screws or C-2 pars screws. It is preformed and is available in a variety of sizes. The authors describe their clinical experience and long-term follow-up experience with the first 22 patients. METHODS: An institutional review board-approved retrospective review of medical records and radiographs was performed for patients who underwent occipitocervical fusion with the Wasatch loop. The mean patient age was 4.9 years (1.2-13 years), and the overall mean follow-up was 4 years (1.5-6.5 years). Six patients had posttraumatic instability, and 16 patients had congenital instability. RESULTS: Twelve patients underwent placement of bilateral C1-2 transarticular screws, 6 patients had placement of a combination of C1-2 transarticular and C-2 pars screws, and 4 patients had placement of bilateral C-2 pars screws. One patient required a halo orthosis; the others were treated postoperatively with a hard cervical collar. All patients had radiographic evidence of solid occipitocervical arthrodesis on last follow-up examination. CONCLUSIONS: The Wasatch loop system is a novel internal fixation device for children who have posttraumatic or congenital occipitocervical instability. Successful arthrodesis was achieved in all patients with minimal use of halo orthoses.
OBJECT: Rigid occipitocervical instrumentation for craniovertebral instability is gaining widespread acceptance for use in pediatric patients; however, most of the instrumentation has been modified from adult-sized hardware. The Wasatch loop system (formerly the Avery-Brockmeyer-Thiokol loop system) is a rigid occipitocervical fixation device designed specifically for use in children. It affixes to the occiput and incorporates either C1-2 transarticular screws or C-2 pars screws. It is preformed and is available in a variety of sizes. The authors describe their clinical experience and long-term follow-up experience with the first 22 patients. METHODS: An institutional review board-approved retrospective review of medical records and radiographs was performed for patients who underwent occipitocervical fusion with the Wasatch loop. The mean patient age was 4.9 years (1.2-13 years), and the overall mean follow-up was 4 years (1.5-6.5 years). Six patients had posttraumatic instability, and 16 patients had congenital instability. RESULTS: Twelve patients underwent placement of bilateral C1-2 transarticular screws, 6 patients had placement of a combination of C1-2 transarticular and C-2 pars screws, and 4 patients had placement of bilateral C-2 pars screws. One patient required a halo orthosis; the others were treated postoperatively with a hard cervical collar. All patients had radiographic evidence of solid occipitocervical arthrodesis on last follow-up examination. CONCLUSIONS: The Wasatch loop system is a novel internal fixation device for children who have posttraumatic or congenital occipitocervical instability. Successful arthrodesis was achieved in all patients with minimal use of halo orthoses.
Authors: Taylor J Abel; Han Yan; Michael Canty; Madison Remick; Michael Dewan; Christopher Witiw; Maria Lamberti-Pasculi; James M Drake Journal: Childs Nerv Syst Date: 2020-06-09 Impact factor: 1.475
Authors: Andrew F Alalade; Elizabeth Ogando-Rivas; Jonathan Forbes; Malte Ottenhausen; Rafael Uribe-Cardenas; Ibrahim Hussain; Prakash Nair; Kurt Lehner; Harminder Singh; Ashutosh Kacker; Vijay K Anand; Roger Hartl; Ali Baaj; Theodore H Schwartz; Jeffrey P Greenfield Journal: World Neurosurg X Date: 2019-01-24