Purpose

The fusion of the upper cervical spine in children is demanding due to its reduced size, its anatomical complexity, or a severe pathology of the cranio-cervical junction. In some pediatric patients with today’s more popular C1–C2 or, occipito-C2 techniques, it is impossible, or very risky to perform a short upper cervical fixation.

Methods

We present the utility and good results of ipsilateral laminar C2 screws insertion technique in two pediatric cases with low C2 laminar profile. Case 1: a 5-year-old child with a C1–C2 unstable subluxation, and a condylar assimilation of C1, where we performed an occipito-C2 fixation using an occipital plate and this modified translaminar C2 screw technique. Case 2: a 8-year-old Down syndrome boy who suffered an unstable subluxation of C1–C2 upon whom we performed a C1–C2 screw fixation using the same technique.

Results

Both cases have been followed up over a period of 7 and 2 years respectively, with good clinical results.

Conclusions

We describe the technique and the feasibility of the ipsilateral insertion of translaminar C2 screws in children with low laminar profiles, as a good alternative to other techniques when the anatomy of the C2 does not permit its use or make them very risky.

中文翻译：

---

同侧经椎板 C2 螺钉插入对低层流儿童颈椎固定的有用性：技术说明

目的

由于其尺寸减小、解剖结构复杂或颅颈交界处的严重病理，儿童上颈椎的融合要求很高。在一些采用当今更流行的 C1-C2 或枕 C2 技术的儿科患者中，进行短的上颈椎固定是不可能的或非常危险的。

方法

我们介绍了同侧 C2 椎板螺钉插入技术在两个具有低 C2 椎板轮廓的儿科病例中的实用性和良好效果。病例 1：一名 5 岁儿童，C1-C2 不稳定半脱位，C1 髁突同化，我们使用枕骨板和这种改良的经椎板 C2 螺钉技术进行枕骨-C2 固定。病例 2：一名 8 岁的唐氏综合症男孩，他的 C1-C2 不稳定半脱位，我们使用相同的技术对其进行了 C1-C2 螺钉固定。

结果

两例病例分别随访7年和2年，临床效果良好。

结论

我们描述了在低层流轮廓儿童中同侧插入经椎板 C2 螺钉的技术和可行性，当 C2 的解剖结构不允许使用或使其非常危险时，作为其他技术的一个很好的替代方案。