Cargando…
Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population
BACKGROUND: Occipitocervical and atlantoaxial instability in the pediatric population is a rare and challenging condition to treat. Variable surgical techniques have been employed to achieve fusion. The study aimed to assess bony fusion with rigid craniocervical fixation using an allograft bone bloc...
Autores principales: | , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Vienna
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156351/ https://www.ncbi.nlm.nih.gov/pubmed/32211968 http://dx.doi.org/10.1007/s00701-020-04287-9 |
_version_ | 1783522186896605184 |
---|---|
author | Groen, Justus L. Peul, Wilco C. Pondaag, Willem |
author_facet | Groen, Justus L. Peul, Wilco C. Pondaag, Willem |
author_sort | Groen, Justus L. |
collection | PubMed |
description | BACKGROUND: Occipitocervical and atlantoaxial instability in the pediatric population is a rare and challenging condition to treat. Variable surgical techniques have been employed to achieve fusion. The study aimed to assess bony fusion with rigid craniocervical fixation using an allograft bone block to serve as scaffold for bony fusion. METHODS: This is a single center case series from a tertiary referral neurosurgical center. The series includes 12 consecutive pediatric patients with rigid craniocervical fusion between 2006 and 2014. The primary outcome was bony fusion as assessed by computed tomography and flexion-extension radiographs. The authors did not receive external funding for this study. RESULTS: Twelve patients (age 1–15 years) were operated with a median imaging follow-up time of 22 months (range 6–69 m). A modified Gallie fusion technique with a tightly wired allograft bone block was used in 10 of 13 procedures. One patient underwent re-fixation due to screw breakage. Eleven out of 13 procedures resulted in a stable construct with bony fusion. All 10 patients operated with the modified Gallie fusion technique with sublaminar wiring of allograft bone block had bony fusion. No post-operative complications of the posterior fixation procedure were noted. CONCLUSIONS: The modified Gallie fusion technique with allograft bone block without post-operative immobilization achieved excellent fusion. We conclude there is no need to use autograft or BMPs in craniocervical fusion in the pediatric population, which avoids related donor-site morbidity. LEVEL OF EVIDENCE: Level IV—case series; therapeutic. |
format | Online Article Text |
id | pubmed-7156351 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer Vienna |
record_format | MEDLINE/PubMed |
spelling | pubmed-71563512020-04-23 Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population Groen, Justus L. Peul, Wilco C. Pondaag, Willem Acta Neurochir (Wien) Original Article - Pediatric Spine BACKGROUND: Occipitocervical and atlantoaxial instability in the pediatric population is a rare and challenging condition to treat. Variable surgical techniques have been employed to achieve fusion. The study aimed to assess bony fusion with rigid craniocervical fixation using an allograft bone block to serve as scaffold for bony fusion. METHODS: This is a single center case series from a tertiary referral neurosurgical center. The series includes 12 consecutive pediatric patients with rigid craniocervical fusion between 2006 and 2014. The primary outcome was bony fusion as assessed by computed tomography and flexion-extension radiographs. The authors did not receive external funding for this study. RESULTS: Twelve patients (age 1–15 years) were operated with a median imaging follow-up time of 22 months (range 6–69 m). A modified Gallie fusion technique with a tightly wired allograft bone block was used in 10 of 13 procedures. One patient underwent re-fixation due to screw breakage. Eleven out of 13 procedures resulted in a stable construct with bony fusion. All 10 patients operated with the modified Gallie fusion technique with sublaminar wiring of allograft bone block had bony fusion. No post-operative complications of the posterior fixation procedure were noted. CONCLUSIONS: The modified Gallie fusion technique with allograft bone block without post-operative immobilization achieved excellent fusion. We conclude there is no need to use autograft or BMPs in craniocervical fusion in the pediatric population, which avoids related donor-site morbidity. LEVEL OF EVIDENCE: Level IV—case series; therapeutic. Springer Vienna 2020-03-24 2020 /pmc/articles/PMC7156351/ /pubmed/32211968 http://dx.doi.org/10.1007/s00701-020-04287-9 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Original Article - Pediatric Spine Groen, Justus L. Peul, Wilco C. Pondaag, Willem Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title | Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title_full | Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title_fullStr | Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title_full_unstemmed | Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title_short | Fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
title_sort | fusion rates support wired allograft combined with instrumented craniocervical fixation in the paediatric population |
topic | Original Article - Pediatric Spine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7156351/ https://www.ncbi.nlm.nih.gov/pubmed/32211968 http://dx.doi.org/10.1007/s00701-020-04287-9 |
work_keys_str_mv | AT groenjustusl fusionratessupportwiredallograftcombinedwithinstrumentedcraniocervicalfixationinthepaediatricpopulation AT peulwilcoc fusionratessupportwiredallograftcombinedwithinstrumentedcraniocervicalfixationinthepaediatricpopulation AT pondaagwillem fusionratessupportwiredallograftcombinedwithinstrumentedcraniocervicalfixationinthepaediatricpopulation |