Abstract
Objectives
To demonstrate that instrumented fusion of the paediatric cervical spine is possible and can be performed safely.
Study Design
A retrospective review of paediatric patients who had instrumented fusion of the cervical spine.
Materials and method
Sixteen paediatric patients (10 male, 6 female) with a mean age of 8 years who underwent instrumented cervical fusion were retrospectively reviewed. Surgery was performed for trauma (5 cases), spinal tuberculosis (3 cases), congenital anomalies (6 cases) and malignancies (2 cases). Fixation methods included occipito-cervical fusion, pedicle and lateral mass screws and anterior cervical plating. Ten posterior approaches, four anterior approaches and four combined anterior and posterior approaches were performed. We looked at fusion rates, blood loss, levels fused, theatre time, technique and complications.
Results
All patients achieved radiological and clinical fusion. The average number of levels fused was 2.5, blood loss 418ml and theatre time 222 minutes for all patients. Anterior procedures had an average of 1 levels fused, blood loss 117ml and theatre time 98 minutes. Posterior procedures had an average number of 1.9 levels fused, blood loss of 306ml and theatre time of 131 minutes. For the combined anterior and posterior procedures the average levels fused were 5.5, blood loss 975ml and theatre time 248 minutes. Five surgery related complications were encountered. These consisted of dural leaks and wound sepsis which were all treated effectively.
Conclusion
The use of modern segmental spinal instrumentation in the paediatric cervical spine is a viable option in this young population. Although our study sample was small we are able to demonstrate that no major surgical complications were encountered due to the use of cervical spinal instrumentation.
NO DISCLOSURES
