scholarly journals Posterior occipitocervical instrumented fusion for atlantoaxial instability in a 27-month-old child with Down syndrome: illustrative case

2021 ◽  
Vol 1 (23) ◽  
Author(s):  
Tetsuro Ohba ◽  
Kotaro Oda ◽  
Nobuki Tanaka ◽  
Wako Masanori ◽  
Tomoka Endo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Down Syndrome ◽  
Pediatric Population ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Rapid Progression ◽  
Illustrative Case ◽  
Left Limb ◽  
Cord Injury ◽  
Irreducible Atlantoaxial Dislocation

BACKGROUND Upper cervical spine instability is one of the most serious orthopedic problems in patients with Down syndrome. Despite the recent advancement of instrumentation techniques, occipitocervical fusion remains technically challenging in the very young pediatric population with small and fragile osseous elements. OBSERVATIONS A 27-month-old boy with Down syndrome was urgently transported to the authors’ hospital because of difficulty in standing and sitting, weakness in the upper limbs, and respiratory distress. Radiographs showed os odontoideum, irreducible atlantoaxial dislocation, and substantial spinal cord compression. Emergency posterior occipitoaxial fixation was performed using O-arm navigation. Improvement in the motor paralysis of the upper left limb was observed from the early postoperative period, but revision surgery was needed 14 days after surgery because of surgical site infection. The patient showed modest but substantial neurological improvement 1 year after the surgery. LESSONS There are several clinical implications of the present case. It warns that Down syndrome in the very young pediatric population may lead to rapid progression of spinal cord injury and life crisis. This 27-month-old patient represents the youngest case of atlantoaxial instability in a patient with Down syndrome. O-arm navigation is useful for inserting screws into very thin pedicles.

C1–2 instability from os odontoideum mimicking intramedullary spinal cord tumor

2011 ◽  
Vol 8 (4) ◽  
pp. 363-366 ◽  
Author(s):  
Paul R. Gigante ◽  
Neil A. Feldstein ◽  
Richard C. E. Anderson
Keyword(s):  
Clinical Presentation ◽  
Pediatric Population ◽  
Spinal Cord Tumor ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Imaging Findings ◽  
Cervical Spine Instability ◽  
Intramedullary Spinal Cord ◽  
Common Cause ◽  
Cord Injury

Os odontoideum is a common cause of atlantoaxial instability in the pediatric population. The authors present the cases of 2 patients whose initial clinical presentation and MR imaging findings were suggestive of an intramedullary neoplasm, but whose ultimate diagnosis was determined to be cervical spine instability and cord injury due to os odontoideum.

scholarly journals Arrow-Shot Injury to Pediatric Spinal Cord

2021 ◽  
Author(s):  
Vijayveer Singh ◽  
Sharad Thanvi
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Pediatric Population ◽  
Cervical Region ◽  
Cervical Cord ◽  
Cord Injury ◽  
Dural Suturing ◽  
Stab Injuries ◽  
Early Surgical Intervention

AbstractPenetrating spinal cord injuries (PSCI) in cervical region are extremely rare in pediatric population. Most injuries in pediatric population are accidental due to gunshot or a stab injury with a sharp or pointed object. Gun shots may result into a severe wound which is usually fatal and may result in death, quadriplegia, or serious long-term disability. Stab injuries are less severe and may result in neurological sequalae. In this paper, an unusual case of pediatric arrow shot partial cervical cord injury is reported which was managed by aggressive neurosurgical management. The arrow lodged in the cervical cord was very near to the vertebral artery leading to parapariesis which recovered well without any complications. Diagnostic imaging at admission included radiographs, computed tomography (CT), and CT angiography of the cervical region. The patient underwent early surgical intervention with removal of foreign body from the cord and subsequent dural suturing.

Restorative rehabilitation entails a paradigm shift in pediatric incomplete spinal cord injury in adolescence: An illustrative case series

2012 ◽  
Vol 5 (4) ◽  
pp. 245-259 ◽  
Author(s):  
Andrea L. Behrman ◽  
Elizabeth Watson ◽  
Guy Fried ◽  
Kelly D'Urso ◽  
Denise D'Urso ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Paradigm Shift ◽  
Case Series ◽  
Illustrative Case ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury

Intracranial Hemorrhage and Spinal Cord Injury From a Fractured C1–C2 Sublaminar Cable

Neurosurgery ◽  
2010 ◽  
Vol 66 (6) ◽  
pp. E1203-E1204 ◽  
Author(s):  
Udaya K. Kakarla ◽  
Juan Valdivia Valdivia ◽  
Volker K.H. Sonntag ◽  
Nicholas C. Bambakidis
Keyword(s):  
Computed Tomography ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cervical Spine ◽  
Mental Status ◽  
Intracranial Hemorrhage ◽  
Subdural Hematoma ◽  
Atlantoaxial Instability ◽  
Cord Injury ◽  
Spine Pathology

Abstract OBJECTIVE This is a unique case report of a fractured atlantoaxial interspinous multistranded cable leading to intracranial hemorrhage and spinal cord injury. CLINICAL PRESENTATION A 61-year-old woman, with a history of rheumatoid arthritis and C1-C2 interspinous wiring with allograft for atlantoaxial instability, presented with neck pain and progressive decline in mental status. Prior to transfer to our institution from a referral hospital, imaging studies revealed progressive hydrocephalus with interval development of subarachnoid and fourth ventricular hemorrhage. Initial and repeat angiographic work-up was negative for vascular lesions. Magnetic resonance imaging revealed a subdural hematoma and signal changes at the cervicomedullary junction. Computed tomography of the cervical spine revealed a fractured interspinous cable, intradural penetration, and atlantoaxial instability. INTERVENTION After ventriculostomy, both the patient's mental status and quadriparesis improved to a C on the American Spinal Injury Association (ASIA) scale. During surgery, the fractured cable and subdural hematoma were removed revealing an area of spinal cord impalement. She underwent C1-C3 lateral mass fixation with iliac crest autograft for fusion and was discharged to rehabilitation after a ventriculoperitoneal shunt was placed. At her 6-month follow-up, she was independent and had improved to ASIA E. Computed tomography confirmed fusion. CONCLUSION Spinal instrumentation eventually fails from pseudarthrosis and can cause neurological injury. In patients with atlantoaxial instability, direct C1-C2 screw fixation with posterior interspinous wiring using autograft offers the best chance for fusion. Cervical spine pathology can cause intracranial hemorrhage, and unconventional causes of injury must be considered when routine workup is negative.

Acute spinal cord injury in pregnancy: an illustrative case and literature review

2003 ◽  
Vol 23 (6) ◽  
pp. 596-598 ◽  
Author(s):  
I Popov ◽  
Faith Ngambu ◽  
G Mantel ◽  
C Rout ◽  
J Moodley
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Literature Review ◽  
Acute Spinal Cord Injury ◽  
Illustrative Case ◽  
Cord Injury ◽  
In Pregnancy

Chronic Spinal Cord Injury in the Pediatric Population

Spine ◽  
2009 ◽  
Vol 34 (1) ◽  
pp. 74-81 ◽  
Author(s):  
Amer F. Samdani ◽  
Reginald S. Fayssoux ◽  
Jahangir Asghar ◽  
James J. McCarthy ◽  
Randal R. Betz ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pediatric Population ◽  
Chronic Spinal Cord Injury ◽  
Cord Injury
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