title: Pediatric bony craniovertebral junction abnormalities: Institutional experience of 10 years.
abstract: OBJECTIVE
  To study the clinical features and treatment outcome of pediatric patients with bony craniovertebral abnormalities.
  
  
  METHODS
  The authors studied 189 consecutive cases of pediatric bony craniovertebral junction abnormalities operated between 2001 and March, 2010.
  
  
  RESULTS
  The pathologies were developmental (n = 162), traumatic (n = 18) and tuberculous (n = 9). Surgical procedures included transoral decompression (n = 118), occipitocervical fusion (OCF, n = 139), C 1 -C 2 fusion (n = 45), and posterior fossa decompression (n = 5). Methods for OCF included contoured stainless steel rods (n = 86), titanium lateral mass screws and plates (n = 47) and steel wires (n = 6). Constructs of all patients of posterior fixation with contoured rods and wires or lateral mass screw and rod who could be followed up were either stable/fused or were fused and stable. No implant failure was noticed among these two surgical procedures. However, 6 patients with C 1-C 2 fusion had broken wires on follow-up requiring repeat posterior fixation. Good neurological outcome was observed even in poor-grade patients. No significant effect on the curvature or growth of the spine was observed at follow-up.
  
  
  CONCLUSIONS
  Pediatric craniovertebral junction anomalies can be managed successfully with good outcomes using a low cost contoured rod and wires.
authors: Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
authors: S S
authors: SS
authors: Kale
authors: Pankaj
authors: P
authors: Ailawadhi
authors: Vamsi Krishna
authors: VK
authors: Yerramneni
authors: P S
authors: PS
authors: Chandra
authors: Rajender
authors: R
authors: Kumar
authors: B S
authors: BS
authors: Sharma
authors: A K
authors: AK
authors: Mahapatra