[Long-term observation of the effect of atlantoaxial fusion on the growth and development of children's cervical spine]

Zhonghua Wai Ke Za Zhi. 2022 Jun 1;60(6):558-566. doi: 10.3760/cma.j.cn112139-20211130-00570.
[Article in Chinese]

Abstract

Objective: To explore the effect of atlantoaxial fusion on the growth and development of children's cervical spine. Methods: The clinical data of 12 children with atlantoaxial dislocation who underwent posterior atlantoaxial fusion at Department of Orthopaedics,the 909th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from June 2002 to September 2013 were retrospective analyzed. There were 7 males and 5 females,with age of (8.1±3.1)years (range:3 to 13 years).Nine cases were traumatic and 3 cases were congenital malformations,1 of the children had Down syndrome. All children underwent posterior atlantoaxial fusion. Furthermore,the information of the height and anteroposterior width of the cervical vertebral bodies and vertical growth rate of the fusion mass were collected from all patients immediately postoperatively and during the follow-up.The range of motion in cervical spine were collected preoperatively and during follow-up period. Data were compared using independent sample t test, paired sample t test and repeated-measurement. Results: All 12 children had regular follow-up within (122.4±25.3)months(range:65 to 163 months). The height and anteroposterior width of the cervical vertebral bodies were similar to these results with those in published reports of growth in normal children of the same age(all P<0.01). At the last follow-up,atlantoaxial fusion of 11 cases had substantial growth (vertical growth rate of the fusion mass:11 cases ≥10%, 1 case <10%);the range of motion in cervical spine was close to the normal level (flexion(55.2±5.0)°,extension (65.3±4.9)°,left bending (41.7±4.5)°,right bending (42.4±4.4)°,left rotation (66.4±5.6)°,right rotation (68.5±5.8)°). Conclusions: Atlantoaxial fusion surgery is satisfactory in the treatment of pediatric atlantoaxial dislocation.During the follow-up,the growth and development of the cervical spine is close to that of normal children of the same age.In long-term observation,it has been found that the operation has no negative effect on the growth and development of the children's cervical spine.

目的: 探讨寰枢椎融合术对儿童颈椎生长发育的影响。 方法: 回顾性分析2002年6月至2013年9月联勤保障部队第九〇九医院骨科收治的12例寰枢椎脱位患儿的临床资料。男性7例,女性5例,年龄(8.1±3.1)岁(范围:3~13岁);其中外伤9例,先天性畸形3例。所有患儿均接受后路寰枢椎融合术。术后即刻及各随访时间点测量患儿颈椎椎体高度、椎体前后径并计算寰枢椎垂直生长率;术前、随访过程中测量患儿颈椎活动度,评价该术式对儿童颈椎生长发育的影响。数据比较采用独立样本t检验、配对样本t检验和重复测量方差分析。 结果: 所有患儿均获得随访,随访时间(122.4±25.3)个月(范围:65~163个月);患儿颈椎椎体高度及前后径与文献报道健康同龄儿童相似(P值均<0.01)。末次随访时,12例患儿中有11例寰枢椎融合节段有实质性生长(寰枢椎垂直生长率:11例≥10%,1例<10%);颈椎活动度接近健康人群水平[前屈(55.2±5.0)°、后伸(65.3±4.9)°、左侧屈(41.7±4.5)°、右侧屈(42.4±4.4)°、左旋转(66.4±5.6)°、右旋转(68.5±5.8)°]。 结论: 寰枢椎融合术治疗儿童寰枢椎脱位疗效满意,患儿随访过程中颈椎生长发育情况接近健康同龄儿童,成年后达到健康人群水平。.

MeSH terms

  • Atlanto-Axial Joint* / abnormalities
  • Atlanto-Axial Joint* / surgery
  • Cervical Vertebrae / surgery
  • Child
  • Congenital Abnormalities
  • Female
  • Growth and Development
  • Humans
  • Joint Dislocations* / surgery
  • Male
  • Retrospective Studies
  • Spinal Fusion* / methods
  • Treatment Outcome

Supplementary concepts

  • Atlanto-Axial Fusion