Ahoud Alharbi1,2,3, Nada Alnefaie4,5, Ali Alkhaibary4,6,7, Adibah Aledrees4,6, Wedad H Almadani8, Modhi Alhussenan5,9, Sami Khairy4,6,7, Wael Alshaya4,6,7,10. 1. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. Alharbi1ahoud@gmail.com. 2. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Alharbi1ahoud@gmail.com. 3. Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Ar Rimayah, Riyadh, 11426, Saudi Arabia. Alharbi1ahoud@gmail.com. 4. College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. 5. National Neuroscience Institute, Department of Neurosurgery, King Fahad Medical City, Riyadh, Saudi Arabia. 6. King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. 7. Division of Neurosurgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Ar Rimayah, Riyadh, 11426, Saudi Arabia. 8. National Center for Evidence Based Healthcare, Saudi Health Council, Riyadh, Saudi Arabia. 9. Alfaisal University, Riyadh, Saudi Arabia. 10. Division of Pediatric Neurosurgery, Department of Pediatric Surgery, King Abdulaziz Medical City, King Abdullah Specialist Children Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Abstract
PURPOSE: Craniocervical junction abnormalities include a wide variety of disorders and can be classified into congenital or acquired. This study aimed to review the surgical outcome of pediatric patients who underwent craniocervical and/or atlantoaxial fusion. METHODS: This is a retrospective cohort study including all pediatric patients (≤ 18 years) who underwent craniocervical and/or atlantoaxial fusion between 2009 and 2019 at quaternary medical city. RESULTS: A total of 25 patients met our criteria and were included in the study. The mean age was 9 years (range: 1-17 years). There was a slight female preponderance (N = 13; 52%). Most patients (N = 16; 64%) had non-trauamatic/chronic causes of craniocervical instability. Most patients presented with neck pain and/or stiffness (N = 14; 56%). Successful fusion of the craniocervical junction was achieved in most patients (N = 21; 84%). Intraoperative complications were encountered in 12% (N = 3) of the patients. Early postoperative complications were observed in five patients (20%). Five patients (20%) experienced long-term complications. Revision was needed in two patients (8%). Older age was significantly associated with higher fusion success rates (p = 0.003). The need for revision surgery rates was significantly higher among younger age group (3.75 ± 2, p = 0.01). CONCLUSIONS: The study demonstrates the surgical outcome of craniocervical and/or atlantoaxial fusion in pediatric patients. Successful fusion of the craniocervical junction was achieved in most patients. Significant association was found between older age and successful fusion, and between younger age and need for revision surgery.
PURPOSE: Craniocervical junction abnormalities include a wide variety of disorders and can be classified into congenital or acquired. This study aimed to review the surgical outcome of pediatric patients who underwent craniocervical and/or atlantoaxial fusion. METHODS: This is a retrospective cohort study including all pediatric patients (≤ 18 years) who underwent craniocervical and/or atlantoaxial fusion between 2009 and 2019 at quaternary medical city. RESULTS: A total of 25 patients met our criteria and were included in the study. The mean age was 9 years (range: 1-17 years). There was a slight female preponderance (N = 13; 52%). Most patients (N = 16; 64%) had non-trauamatic/chronic causes of craniocervical instability. Most patients presented with neck pain and/or stiffness (N = 14; 56%). Successful fusion of the craniocervical junction was achieved in most patients (N = 21; 84%). Intraoperative complications were encountered in 12% (N = 3) of the patients. Early postoperative complications were observed in five patients (20%). Five patients (20%) experienced long-term complications. Revision was needed in two patients (8%). Older age was significantly associated with higher fusion success rates (p = 0.003). The need for revision surgery rates was significantly higher among younger age group (3.75 ± 2, p = 0.01). CONCLUSIONS: The study demonstrates the surgical outcome of craniocervical and/or atlantoaxial fusion in pediatric patients. Successful fusion of the craniocervical junction was achieved in most patients. Significant association was found between older age and successful fusion, and between younger age and need for revision surgery.
Authors: R Shane Tubbs; Justin D Hallock; Virginia Radcliff; Robert P Naftel; Martin Mortazavi; Mohammadali M Shoja; Marios Loukas; Aaron A Cohen-Gadol Journal: J Neurosurg Spine Date: 2011-03-11