Abstract
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.
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Acknowledgments
We are thankful you all the staff of the library of the University Hospital Miguel Servet, and to David Andrew Brierley for his help with the revision of the paper.
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JO and LBL conceived the study and develop it in discussion with JMH, JCP, DFM, and BCS. JO, JCP, and BCS collected the data. JO designed the study. JO drafted the manuscript which was reviewed by all the authors. JO drew the figures.
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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
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Previous Presentations
One of the cases was presented as a Poster in the EANS (European Association of Neurological Societies) meeting 2014.
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Orduna Martínez, J., López López, L.B., Moles Herbera, J.A. et al. Usefulness of ipsilateral translaminar C2 screws insertion for cervical fixation in children with a low laminar profile: a technical note. Childs Nerv Syst 37, 291–294 (2021). https://doi.org/10.1007/s00381-020-04899-7
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DOI: https://doi.org/10.1007/s00381-020-04899-7