title: Atlanto-occipital fusion for dislocation in children with neurologic preservation. A case report.
abstract: METHODS
  A retrospective clinical review of patients with atlanto-occipital dislocations.
  
  
  OBJECTIVE
  To determine if fusion of the occiput to C1 can be accomplished without extension to the axis.
  
  
  BACKGROUND
  Patients with atlanto-occipital dislocations who have preservation of spinal cord function are quite rare. The standard approach to stabilization has been fusion of the occiput to the axis (C2). This may compromise rotation unnecessarily, however. The authors investigated the success of attempting to fuse only the occiput to C1 in children.
  
  
  METHODS
  Two children with atlanto-occipital dislocation who had normal neurologic function underwent fusion from the occiput to the atlas after reduction.
  
  
  RESULTS
  Both cases showed successful fusion with no unwanted extension to lower levels. Full head rotation was preserved.
  
  
  CONCLUSIONS
  This technique restores stability without restricting rotation.
authors.affiliation: Department of Arthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Sponseller
authors.forename: J R
authors.initials: JR
authors.lastname: Cass
mesh_terms: D001269:Atlanto-Occipital Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009460:Neurologic Examination; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion