Abstract:
OBJECTIVE:Malformations in the craniocervical junction (CCJ) are rare in the pediatric population but often need surgical treatment. We present a pediatric case series of patients treated with a 2-stage surgical approach with a halo vest and occipitocervical fusion and review complications and outcomes. METHODS:A retrospective analysis of a single-center case series was performed. Pediatric patients affected by congenital craniocervical junction anomalies and treated with a 2-stage approach were included. A halo vest was implanted in the first surgery, and ambulatory progressive reduction was performed. When a favorable anatomic situation was observed, arthrodesis was performed. Safety analysis was undertaken by analyzing the incidence of complications in both procedures. Effectivity analysis was carried out analyzing radiologic and clinical outcome (Goel grade and modified Japanese Orthopaedic Association score). Student t test was used for statistical analysis. RESULTS:Sixteen cases were included. Mean age of patients was 9.38 years. Safety analysis showed 2 halo loosenings, 1 pin infection, 2 wound infections, 1 cerebrospinal fluid leak, and 2 delayed broken rods. No major complications were observed. Radiologic analysis showed an improvement in the tip of the odontoid process to the McRae line distance (from -3.26 mm to -6.16 mm), atlantodental interval (from 3.05 mm to 1.88 mm), clival-canal angle (from 134.61° to 144.38°), and cervical kyphosis (from 6.39° to 1.54°). Clinical analysis also showed improvement in mean Goel grade (from 1.75 to 1.44) and modified Japanese Orthopaedic Association score (from 15.12 to 16.41). CONCLUSIONS:The 2-stage approach was a suitable and effective treatment for craniocervical junction anomalies in pediatric patients.
journal_name
World Neurosurgjournal_title
World neurosurgeryauthors
Tirado-Caballero J,Moreno-Madueño G,Rivero-Garvia M,Mayorga-Buiza MJ,Valencia-Anguita J,Márquez-Rivas Jdoi
10.1016/j.wneu.2020.11.079subject
Has Abstractpub_date
2020-11-20 00:00:00eissn
1878-8750issn
1878-8769pii
S1878-8750(20)32454-2pub_type
杂志文章abstract:OBJECTIVE:Anatomy of the posterior ascending artery (PAA) has been well documented. The PAA forms an apical arcade, which supplies the small branches to the tip of the dens. However, morphometrics of this artery such as diameter and distance from the midline, which could be applied to the diagnosis and surgical procedu...
journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
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journal_title:World neurosurgery
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doi:10.1016/j.wneu.2017.05.162
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.04.069
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pub_type: 杂志文章,meta分析,评审
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更新日期:2018-04-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
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journal_title:World neurosurgery
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journal_title:World neurosurgery
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 历史文章,杂志文章
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更新日期:2012-09-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2010.02.003
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pub_type: 杂志文章
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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journal_title:World neurosurgery
pub_type: 杂志文章
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更新日期:2017-03-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2013.01.046
更新日期:2013-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2019.07.064
更新日期:2019-10-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章
doi:10.1016/j.wneu.2016.08.095
更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-12-01 00:00:00
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journal_title:World neurosurgery
pub_type: 杂志文章,评审
doi:10.1016/j.wneu.2013.02.072
更新日期:2013-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2017-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.wneu.2020.04.046
更新日期:2020-07-01 00:00:00