Rigid Segmental Cervical Spine Instrumentation is Safe and ...

Rigid Segmental Cervical Spine Instrumentation is Safe and ...

Rigid Segmental Cervical Spine Instrumentation is Safe and Efficacious in Younger Children Ana Mitchell, BS Vidyadhar V. Upasani, MD Carrie E. Bartley, MA Peter O. Newton, MD Burt Yaszay, MD Disclosure

Ana Mitchell, BS - none Vidyadhar Upasani, MD - Orthopediatrics consultant, speaker bureau Carrie Bartley, MA None Peter Newton, MD Depuy Synthes royalties, consultant, speaker bureau, grants; K2M speaker bureau, consultant, grant; Cubist consultant; Electrocore stock Burt Yaszay, MD Depuy Synthes consultant, speaker bureau, grants; Nuvasive consultant, speaker bureau; K2M consultant, royalties; Orthopediatrics royalties; Stryker speaker bureau

Introduction The utilization of cervical spine instrumentation in the young pediatric patient in not well reported in the literature. Kennedy et al J Neurosurg Ped 2016 less than 6 yo Occ-cervical and AA fusion good results Hedequist HSS 2015 review article Hwang et al J Neurosurg Spine 8.3 ave age Multiple case reports

Purpose To report on the safety and efficacy of cervical spine instrumentation in the young pediatric population Methods

Retrospective Review Single institution January 1, 2006 and March 31, 2015. Age 10 years at the time of surgery Any diagnosis Methods

Clinical data demographics, diagnosis, procedure Radiographic data (pre and postop) Results 20 children mean f/u 10 mo Initial indication for cervical spine correction surgery included deformity (7) trauma (6)

instability (3) stenosis (2) rotary subluxation (1) infection (1) Results Surgical Info 15 cases - adult 3.5mm cervical spine instrumentation 3 with wiring (1 sublaminar, 2 spinous process) 2 with cannulated screws (3.5 mm)

Postop immobilization 16 Halo fixations 3 collars 1 CTO. Results Overall there were 5 major complications related to the surgery. Nonunion 1 sublaminar and 1 spinous wiring

18 mo traumatic AOD 23 mo traumatic C4-5 distraction injury 1 dural tear/CSF leak requiring a lumbar drain 1 wound infection I&D Results 2 neurologic complications (in 2 deformity patients) 1 loss of lower extremity signals intraop,

decreased sensory/motor function post-op. 1 left arm weakness deformity correction None were associated with c-spine instrumentation deformity correction Conclusion Rigid segmental fixation can be safe and efficacious when used in pediatric cervical

spine patients. Whether used with Halo or orthosis, patients experience minimal to no complications from the instrumentation and achieved successful fusion. Conclusion Cervical spine wiring on the other hand had a high risk of non-union requiring revision surgery (66%).

All underwent successful revision with segmental fixation

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