A Novel Instrumentation Approach in a Pediatric Patient with Atlanto-Occipital Dislocation and Cervical Fracture: Case Report

John Souter, Kevin Swong, Elhaum Rezaii, G. Alexander Jones*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Although instrumented stabilization of pediatric atlanto-occipital dislocation (AOD) has been described in the literature, there is little evidence regarding instrumentation techniques in pediatric patients presenting with both AOD and a cervical fracture. We present a case of a 2-year-old male involved in a motor vehicle collision with an unstable C2 fracture and AOD, treated with an occiput-C4 posterior arthrodesis using a rod, crosslink, and cable construct. Case Description: This patient suffered a type III C2 fracture and AOD with 4 mm craniocaudal and 3 mm anterior displacement. In the operating room, 2 cobalt chrome connecting rods (3.5 mm) were connected to 1 another with crosslinks at C2 and C4. These were affixed with suboccipital and sublaminar cables at C1, C2, and C4. At 14 months postoperatively, his spine is clinically and radiographically stable. He has spontaneous movement in all 4 extremities, and remains in a persistent vegetative state because of his underlying central nervous system injury. Conclusions: Although there is a breadth of literature investigating instrumentation approaches to pediatric AOD, there is minimal evidence on outcomes of patients presenting with both AOD and cervical fracture. The technique we describe has proven safe and effective for this patient.

Original languageEnglish (US)
Pages (from-to)70-72
Number of pages3
JournalWorld neurosurgery
Volume136
DOIs
StatePublished - Apr 2020
Externally publishedYes

Keywords

  • Atlanto-occipital dislocation
  • Cervical fracture
  • Contoured loop and wire
  • Pediatric

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'A Novel Instrumentation Approach in a Pediatric Patient with Atlanto-Occipital Dislocation and Cervical Fracture: Case Report'. Together they form a unique fingerprint.

Cite this