title: Screw fixation for atlantoaxial dislocation related to Down syndrome in children younger than 5 years.
abstract: The aim of this study was to present cases of upper cervical fixation in Down syndrome patients younger than 5 years. In two cases, C1 lateral mass screws were installed. However, owing to the irreducible atlantoaxial dislocation, the screw backed out and fractured. Therefore, O-C2 fusion was performed. Furthermore, C2 bilateral lamina screws were added to the C2 pedicle screw for reinforcement. C1-C2 fusion is an option for Down syndrome patients younger than 5 years with atlantoaxial dislocation, when the dislocation is reducible. If the dislocation is irreducible, or the implant cannot be firmly secured, the fixation range should be expanded to O-C2 or below.
authors.affiliation: Department of Orthopaedic Surgery, Nagoya University Hospital, Graduate School of Medicine, Nagoya-City, Aichi, Japan.
authors.forename: Kenyu
authors.initials: K
authors.lastname: Ito
authors.forename: Shiro
authors.initials: S
authors.lastname: Imagama
authors.forename: Zenya
authors.initials: Z
authors.lastname: Ito
authors.forename: Kei
authors.initials: K
authors.lastname: Ando
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Hida
authors.forename: Yoshimoto
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Naoki
authors.initials: N
authors.lastname: Ishiguro
mesh_terms: D001268:Atlanto-Axial Joint / Q000601:surgery*; D001863:Bone Screws; D002574:Cervical Vertebrae / Q000601:surgery; D002675:Child, Preschool; D019299:Decompression, Surgical; D004314:Down Syndrome / Q000150:complications*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000150:complications*; D007593:Joint Instability / Q000601:surgery; D013123:Spinal Fusion