Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population
| Autor: | Willem Pondaag, Justus L. Groen, Wilco C. Peul |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Joint Instability
Male medicine.medical_specialty Adolescent Radiography Bone Screws Craniocervical instability Single Center 030218 nuclear medicine & medical imaging 03 medical and health sciences Fixation (surgical) 0302 clinical medicine Postoperative Complications Allograft Medicine Humans Child Children Neuroradiology Fusion Bone Transplantation medicine.diagnostic_test business.industry Infant Bone fusion Interventional radiology Surgical technique Surgery Spinal Fusion Treatment Outcome Atlanto-Axial Joint Atlantoaxial instability Original Article - Pediatric Spine Child Preschool Female Neurology (clinical) Neurosurgery business Tomography X-Ray Computed 030217 neurology & neurosurgery |
| Zdroj: | Acta Neurochirurgica, 162(5), 985-991. SPRINGER WIEN Acta Neurochirurgica |
| DOI: | 10.1007/s00701-020-04287-9 |
| Popis: | BackgroundOccipitocervical and atlantoaxial instability in the pediatric population is a rare and challenging condition to treat. Variable surgical techniques have been employed to achieve fusion. The study aimed to assess bony fusion with rigid craniocervical fixation using an allograft bone block to serve as scaffold for bony fusion.MethodsThis is a single center case series from a tertiary referral neurosurgical center. The series includes 12 consecutive pediatric patients with rigid craniocervical fusion between 2006 and 2014. The primary outcome was bony fusion as assessed by computed tomography and flexion-extension radiographs. The authors did not receive external funding for this study.ResultsTwelve patients (age 1–15 years) were operated with a median imaging follow-up time of 22 months (range 6–69 m). A modified Gallie fusion technique with a tightly wired allograft bone block was used in 10 of 13 procedures. One patient underwent re-fixation due to screw breakage. Eleven out of 13 procedures resulted in a stable construct with bony fusion. All 10 patients operated with the modified Gallie fusion technique with sublaminar wiring of allograft bone block had bony fusion. No post-operative complications of the posterior fixation procedure were noted.ConclusionsThe modified Gallie fusion technique with allograft bone block without post-operative immobilization achieved excellent fusion. We conclude there is no need to use autograft or BMPs in craniocervical fusion in the pediatric population, which avoids related donor-site morbidity.Level of evidenceLevel IV—case series; therapeutic. |
| Databáze: | OpenAIRE |
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