Instrumented fusion in a 12-month-old with atlanto-occipital dislocation: case report and literature review of infant occipitocervical fusion. 2017

Andrew T Hale, and Michael C Dewan, and Bhairav Patel, and Matthew J Geck, and Luke D Tomycz
Department of Neurosurgery, Vanderbilt University School of Medicine, T4224 Medical Center North, Nashville, TN, 37232, USA.

BACKGROUND The treatment of atlantoaxial dislocation in very young children is challenging and lacks a consensus management strategy. CONCLUSIONS We review the literature on infantile occipitocervical (OC) fusion is appraised and technical considerations are organized for ease of reference. Surgical decisions such as graft type and instrumentation details are summarized, along with the use of bone morphogenic protein and post-operative orthoses. METHODS We present the case of a 12-month-old who underwent instrumented occipitocervical (OC) fusion in the setting of traumatic atlanto-occipital dislocation (AOD). CONCLUSIONS Occipitocervical (OC) arthrodesis is obtainable in very young infants and children. Surgical approaches are variable and use a combination of autologous grafting and creative screw and/or wire constructs. The heterogeneity of pathologic etiology leading to OC fusion makes it difficult to make definitive recommendations for surgical management.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D009777 Occipital Bone Part of the back and base of the CRANIUM that encloses the FORAMEN MAGNUM. Basilar Bone,Basilar Bones,Bone, Basilar,Bone, Occipital,Bones, Basilar,Bones, Occipital,Occipital Bones
D010264 Paraplegia Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness. Paralysis, Lower Extremities,Paraplegia, Spastic,Spastic Paraplegia,Paralysis, Legs,Paralysis, Lower Limbs,Paraplegia, Ataxic,Paraplegia, Cerebral,Paraplegia, Flaccid,Paraplegia, Spinal,Ataxic Paraplegia,Ataxic Paraplegias,Cerebral Paraplegia,Cerebral Paraplegias,Flaccid Paraplegia,Flaccid Paraplegias,Paraplegias,Paraplegias, Ataxic,Paraplegias, Cerebral,Paraplegias, Flaccid,Paraplegias, Spastic,Paraplegias, Spinal,Spastic Paraplegias,Spinal Paraplegia,Spinal Paraplegias
D001863 Bone Screws Specialized devices used in ORTHOPEDIC SURGERY to repair bone fractures. Bone Screw,Screw, Bone,Screws, Bone
D004204 Joint Dislocations Displacement of bones from their normal positions at a joint. Inferior Dislocation,Joint Subluxations,Luxatio Erecta,Dislocation, Joint,Dislocations, Joint,Inferior Dislocations,Joint Dislocation,Joint Subluxation,Subluxation, Joint,Subluxations, Joint
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001269 Atlanto-Occipital Joint The point of articulation between the OCCIPITAL BONE and the CERVICAL ATLAS. Atloido-Occipital Joint,Atlanto Occipital Joint,Atlanto-Occipital Joints,Atloido Occipital Joint,Atloido-Occipital Joints,Joint, Atlanto-Occipital,Joint, Atloido-Occipital,Joints, Atlanto-Occipital,Joints, Atloido-Occipital
D013123 Spinal Fusion Operative immobilization or ankylosis of two or more vertebrae by fusion of the vertebral bodies with a short bone graft or often with diskectomy or laminectomy. (From Blauvelt & Nelson, A Manual of Orthopaedic Terminology, 5th ed, p236; Dorland, 28th ed) Spondylodesis,Spondylosyndesis,Fusion, Spinal,Fusions, Spinal,Spinal Fusions,Spondylodeses,Spondylosyndeses
D014057 Tomography, X-Ray Computed Tomography using x-ray transmission and a computer algorithm to reconstruct the image. CAT Scan, X-Ray,CT Scan, X-Ray,Cine-CT,Computerized Tomography, X-Ray,Electron Beam Computed Tomography,Tomodensitometry,Tomography, Transmission Computed,X-Ray Tomography, Computed,CAT Scan, X Ray,CT X Ray,Computed Tomography, X-Ray,Computed X Ray Tomography,Computerized Tomography, X Ray,Electron Beam Tomography,Tomography, X Ray Computed,Tomography, X-Ray Computer Assisted,Tomography, X-Ray Computerized,Tomography, X-Ray Computerized Axial,Tomography, Xray Computed,X Ray Computerized Tomography,X Ray Tomography, Computed,X-Ray Computer Assisted Tomography,X-Ray Computerized Axial Tomography,Beam Tomography, Electron,CAT Scans, X-Ray,CT Scan, X Ray,CT Scans, X-Ray,CT X Rays,Cine CT,Computed Tomography, Transmission,Computed Tomography, X Ray,Computed Tomography, Xray,Computed X-Ray Tomography,Scan, X-Ray CAT,Scan, X-Ray CT,Scans, X-Ray CAT,Scans, X-Ray CT,Tomographies, Computed X-Ray,Tomography, Computed X-Ray,Tomography, Electron Beam,Tomography, X Ray Computer Assisted,Tomography, X Ray Computerized,Tomography, X Ray Computerized Axial,Transmission Computed Tomography,X Ray Computer Assisted Tomography,X Ray Computerized Axial Tomography,X Ray, CT,X Rays, CT,X-Ray CAT Scan,X-Ray CAT Scans,X-Ray CT Scan,X-Ray CT Scans,X-Ray Computed Tomography,X-Ray Computerized Tomography,Xray Computed Tomography

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