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Most children showed good alignment after atlantoaxial or occipitocervical fusion
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Researchers of this study found most children who underwent atlantoaxial or occipitocervical fusion procedures do not develop long-term consequences, altered growth or alignment of the cervical spine.
Researchers conducted a retrospective chart review of 40 children who underwent occipitocervical (OC) or atlantoaxial (AA) fusion with rigid instrumentation at nine centers. Each patient had at least 3 years of clinical and radiographic follow-up data and confirmed fusion. In all, nine patients underwent AA fusion and 31 patients underwent OC fusion.
At final follow-up, investigators found 85% of patients had good alignment. No radiological indicators of subaxial instability, such as osteophytes, new or worsened spondylolisthesis, new unintended subaxial fusion or abnormal movement on flexion-extension radiographs, were present at final follow-up. No patients developed a new kyphosis or swan-neck deformity, had evidence of subaxial instability or unintended subaxial fusion.
Three different vertical growth patterns of the fusion developed among the OC patients. In total, 16 had substantial growth; nine had no meaningful growth; and six had a decrease in height of the fused levels. In AA patients, the mean percentage of cervical growth within the fusion mass was 30%, researchers wrote.
Variation in vertical growth and alignment did exist, and this highlights the need for a long-term follow-up, researchers concluded. – by Robert Linnehan
Disclosure: The researchers report no relevant financial disclosures.
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