title: Challenges of Transarticular Screw Fixation in Young Children: Report of Surgical Treatment of a 5-Year-Old Patient's Unstable Os-Odontoideum.
abstract: Surgical procedures for atlantoaxial (C1-C2) fusion in young children are relatively uncommon. The purpose of this study was to report on a surgical treatment for a case of atlantoaxial instability caused by os-odontoideum in association with quadriparesis and respiratory paralysis in a 5-year-old girl. We present the patient's history, physical examination, and radiographic findings, describe the surgical treatment and a five year follow-up, and provide a literature review. The instability was treated by halo immobilization, followed by C1-C2 transarticular screw fixation using a computed tomography-based navigation system. At the five year follow-up, the patient had made a complete recovery with solid union. The authors conclude that C1-2 transarticular screw fixation is technically possible as in a case of atlantoaxial instability in a five-year-old child.
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Jun
authors: J
authors: Takahashi
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Hiroki
authors: H
authors: Hirabayashi
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Hiroyuki
authors: H
authors: Hashidate
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Nobuhide
authors: N
authors: Ogihara
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Keijiro
authors: K
authors: Mukaiyama
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Masatoshi
authors: M
authors: Komatsu
authors: Department of Pediatrics, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Yuji
authors: Y
authors: Inaba
authors: Department of Medical Genetics, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Tomoki
authors: T
authors: Kosho
authors: Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors: Hiroyuki
authors: H
authors: Kato
keywords: Atlantoaxial instability; C1-C2 Transarticular screw fixation; CT-based navigation system; Os-odontoideum; Young children