title: Incorporation of C-1 lateral mass screws in occipitocervical and atlantoaxial fusions for children 8 years of age or younger. Technical note.
abstract: The authors describe the novel use of C-1 lateral mass screws in four children 8 years of age or younger, in whom occipitocervical or atlantoaxial fusion was performed for trauma or os odontoideum. The authors retrospectively reviewed the demographics and procedural data of four children, ranging in age from 2 to 8 years, who required and underwent surgical fixation. Although C1-2 screw/rod constructs involving individual C-1 lateral mass screws and C-2 pars interarticularis or pedicle screws have been widely applied in adults, only C1-2 transarticular screw fixation has been reported in children less than 8 years of age. This report demonstrates the successful results of rigid occipitocervical and atlantoaxial fusion in four children in whom C-1 lateral mass screws were placed as part of a screw/rod construct. There was one instance of a vertebral artery injury, and the lessons learned from this complication are discussed.
authors.affiliation: Division of Neurosurgery, Department of Surgery, Hospital for Sick Children, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada. andrew_jea@mindspring.com
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea
authors.forename: Michael D
authors.initials: MD
authors.lastname: Taylor
authors.forename: Peter B
authors.initials: PB
authors.lastname: Dirks
authors.forename: Abhaya V
authors.initials: AV
authors.lastname: Kulkarni
authors.forename: James T
authors.initials: JT
authors.lastname: Rutka
authors.forename: James M
authors.initials: JM
authors.lastname: Drake
mesh_terms: D000367:Age Factors; D001268:Atlanto-Axial Joint; D001269:Atlanto-Occipital Joint; D001863:Bone Screws; D002574:Cervical Vertebrae; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D007593:Joint Instability / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D013123:Spinal Fusion / Q000295:instrumentation*