![]() ![]() Preoperative CT and MRI were performed to check the OsO and spinal cord compression, signal changes and spinal cord injury grade (ASIA grade) ( 8). This study was approved by the Medical research ethics committee of Hebei children’s Hospital (2021-88). Children not followed up for more than 18 months (including revision cases) were excluded. The inclusion criteria were children with the atlanto-dens interval (ADI) greater than 5 mm according to imaging examination. Materials and Methods Patientsįive continuous children diagnosed with DS who underwent posterior atlantoaxial screw fixation or occipitocervical fusion from January 2017 to January 2020 in Hebei Children’s Hospital were retrospectively included. Therefore, this study retrospectively analyzed and summarized the clinical data of 5 cases of atlantoaxial dislocation diagnosed with DS admitted to our hospital from 2017 to 2020, aiming to explore the clinical characteristics of atlantoaxial instability (AAI) or atlantoaxial dislocation (AAD) caused by pediatric DS and the effect of surgical treatment with posterior atlantoaxial screw fixation. However, there are few reports of internal fixation system therapy. Currently, the treatment of CVJ instability in children with DS, especially atlantoaxial dislocation, was mainly based on braces and halo external fixators, with poor treatment effects and many complications ( 7). Some children may develop atlantoaxial dislocation after minor trauma, resulting in severe spinal cord injury. Patients with DS are more prone to CVJ instability than the general population due to low bone density, inherent ligamentous laxity, high joint flexion, odontoid hypoplasia, and os odontoideum (OsO) ( 5, 6). Although CVJ instability is mostly asymptomatic ( 3, 4), the initial presentation of cervical instability can be catastrophic, often accompanied by respiratory insufficiency and potential risk of death. One-third of DS patients involve instability of the craniocervical junction (CVJ) ( 2), which is the main cervical spine problem in children with DS. Children with DS often have obvious growth retardation and multiple deformities ( 1). Postoperative head-neck-chest braces are necessary for children, especially those with occipitocervical fusion.ĭown’s syndrome (DS), or trisomy 21, is a disorder caused by a chromosomal abnormality (an extra chromosome 21). At the last follow-up, all cases were fused and the neurological function were all ASIA grade E.Ĭonclusion: After posterior atlantoaxial screw fixation, fusion and nerve recovery were achieved in all children with atlantoaxial dislocation and OsO. 1 case had internal fixation breakage of the prosthetic joint and underwent revision surgery. 1 case had dural tear and recovered well after timely suturing. All 5 cases wore the head-neck-chest brace for 3–6 months after the operation. Every child underwent posterior atlantoaxial screw fixation (3.5-mm diameter), and the average fusion level was 1.8 (1–2). Among which 60% (3/5) of children had changes in spinal cord signals and 40% (2/5) had dural sac compression. Results: All 5 children have atlantoaxial dislocation and OsO. Preoperative CT and MRI were performed to check the os odontoideum (OsO) and spinal cord compression, signal changes and spinal cord injury grade (ASIA grade). Methods: Children diagnosed with DS who underwent posterior atlantoaxial screw fixation or occipitocervical fusion from January 2017 to January 2020 in Hebei Children’s Hospital were retrospectively included. 2Department of Orthopedic, Children’s Hospital of Hebei Province, Shijiazhuang, Chinaīackground: To investigate the effect of posterior atlantoaxial screw fixation for the treatment of atlantoaxial dislocation in children with Down syndrome (DS).1Department of Orthopedic, Beijing Children’s Hospital, Capital Medical University, Beijing, China.Chengxin Li 1† Yiren Tian 2*† Qiang Ren 2 Xiangqian Ji 2 Ziwei Mao 2 Ming Wu 2 ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |