Surgical treatment of the children with serious atlantoaxial instability

Abstract

Objective To study surgical treatment of the children with serious atlantoaxial instability. Methods The surgical results of 22 children associated with serious atlantoaxial instability were reviewed. There were 16 boys and 6 girls, with their age ranging from 3 to 14 years (mean 11.4). Etiologies included dens fracture, disrupted transverse ligament, congenital anomalies of occipito-cervical,rheumatoid arthritis. All patients had posterior arthrodesis of the upper cervical spine. Atlantoaxial fusion was used to treat 14 patients. Occipito-cervical fusion was chosen for 8 patients. Results 20 patients were followed up for an average of 20 months (rang 3 months～11 years) and satisfactory results were demonstrated. All of them achieved solid osseous unions. Conclusions Fusion of the upper cervical spine was an effective procedures to treat children with atlantoaxial instability. Atlantoaxial fusion was chosen for the patient in who reduction of the atlantoaxial dislocation was feasible before surgery. The patient with irreducible atlantoaxial dislocation was treated by occipito-cervical fusion.