Taylor J Abel1,2, Han Yan3, Michael Canty3, Madison Remick4, Michael Dewan4, Christopher Witiw3, Maria Lamberti-Pasculi3, James M Drake3. 1. Division of Neurosurgery, The Hospital for Sick Children, Toronto, Canada. abeltj@upmc.edu. 2. Department of Neurological Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. abeltj@upmc.edu. 3. Division of Neurosurgery, The Hospital for Sick Children, Toronto, Canada. 4. Department of Neurological Surgery, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Abstract
OBJECT: Traumatic atlanto-occipital dislocation (AOD) is a relatively uncommon traumatic cervical spine injury characterized by disruption and instability of the atlanto-occipital joint. At many centers, management of pediatric AOD includes occipitocervical arthrodesis, but whether external immobilization without surgery is a viable treatment option for some pediatric patients is unknown. To answer this question, we analyzed our outcomes of pediatric AOD at the Hospital for Sick Children. METHODS: We performed a retrospective chart review of all children with clinical and radiographic evidence of traumatic AOD. A total of 10 patients met criteria for traumatic AOD: 8 were treated with external immobilization alone and 2 were treated with occipitocervical arthrodesis. RESULTS: Eight patients were treated exclusively with 3 months of halo immobilization. Two patients were treated with occipitocervical instrumentation and arthrodesis. No patient undergoing halo immobilization required subsequent operative fusion. CONCLUSION: Halo immobilization is a safe, viable, and definitive treatment option for the selected children with AOD.
OBJECT: Traumatic atlanto-occipital dislocation (AOD) is a relatively uncommon traumatic cervical spine injury characterized by disruption and instability of the atlanto-occipital joint. At many centers, management of pediatric AOD includes occipitocervical arthrodesis, but whether external immobilization without surgery is a viable treatment option for some pediatric patients is unknown. To answer this question, we analyzed our outcomes of pediatric AOD at the Hospital for Sick Children. METHODS: We performed a retrospective chart review of all children with clinical and radiographic evidence of traumatic AOD. A total of 10 patients met criteria for traumatic AOD: 8 were treated with external immobilization alone and 2 were treated with occipitocervical arthrodesis. RESULTS: Eight patients were treated exclusively with 3 months of halo immobilization. Two patients were treated with occipitocervical instrumentation and arthrodesis. No patient undergoing halo immobilization required subsequent operative fusion. CONCLUSION:Halo immobilization is a safe, viable, and definitive treatment option for the selected children with AOD.
Entities:
Keywords:
Atlanto-occipital dissociation; Motor vehicle collisions; Pediatric neurosurgery; Spine; Trauma
Authors: M Ehlinger; Y-P Charles; P Adam; G Bierry; J-C Dosch; J-P Steib; F Bonnomet Journal: Orthop Traumatol Surg Res Date: 2011-01-26 Impact factor: 2.256
Authors: Shao-Jie Zhang; Kun Li; Zhi-Jun Li; Xing Wang; Jia-Hui Dong; Jian Wang; Jie Chen; Xing-Yue Qu; Zi-Yu Li; Yu-Hang Liu Journal: Int J Gen Med Date: 2021-09-16