Pediatric congenital atlantoaxial dislocation: differences between the irreducible and reducible varieties

Journal of Neurosurgery
P SalunkeVijendra K Jain

Abstract

Clinicoradiological differences and outcome following surgery in pediatric patients (< or = 16 years of age) with congenital irreducible atlantoaxial dislocation (IAAD) and reducible atlantoaxial dislocation (RAAD) were analyzed. Ninety-six patients (57 with IAAD and 39 with RAAD) were categorized as follows: Grade I, no deficits except hyperreflexia or neck pain (six patients); Grade II, minor deficits but independent for activities of daily living (25); Grade III, partially dependent (30); and Grade IV, totally dependent (35). Patients with RAAD underwent direct posterior fusion, and those with IAAD were treated with transoral decompression and posterior fusion. Patients with good outcomes included those who could walk unaided, with improvement in spasticity and weakness, and those who maintained Grade I status. The category of poor outcome included patients with the following conditions: postoperative deterioration or lack of improvement; inability to ambulate regardless of neurological improvement at a minimum follow-up duration of 3 months; or perioperative death. A significantly higher incidence of C-1 assimilation, C2-3 fusion, asymmetrical occiput-C2 facet joints, and basilar invagination were seen in patients with IAAD...Continue Reading

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Citations

Jul 15, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Xiang WangZhen-Hua Liu
Dec 17, 2009·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Chao Wang, Shenglin Wang
Aug 23, 2011·Journal of Neurosurgery. Spine·Pravin SalunkeNiranjan K Khandelwal
Mar 13, 2012·Neurology India·Vijendra K Jain
Sep 18, 2010·Surgical Neurology International·Fraser C HendersonEdward Benzel
Jan 14, 2016·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Pravin SalunkeN K Khandelwal
Feb 24, 2015·World Neurosurgery·Nauman S ChaudhryIan F Dunn
Oct 29, 2011·Neuroimaging Clinics of North America·Shilpa S Sankhe, S K Susheel Kumar
Nov 15, 2016·Neurology India·Pavaman SindgikarSanjay Behari
Feb 20, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ranjith K Moorthy, Vedantam Rajshekhar
Nov 18, 2017·Journal of Neurosurgery. Spine·Xinghuo WuCao Yang
Dec 14, 2007·Journal of Neurosurgery. Spine·Mandakini PradhanVijendra K Jain
Sep 17, 2011·Pediatric Neurosurgery·Vamsi Krishna YerramneniAshok Kumar Mahapatra
Aug 2, 2014·Global Spine Journal·Sun Y YangPeter G Passias
Jul 28, 2021·Journal of Korean Neurosurgical Society·Man Kyu ChoiJun Ho Lee

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