Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Children's Orthopaedic Center, Children's Hospital Los Angeles, Los Angeles, California.
JBJS Case Connect. 2021 Mar 17;11(1):01709767-202103000-00052. doi: e20.00456.
There is a paucity of literature regarding pediatric upper cervical spine traumatic instability, atlanto-occipital dislocations, and fractures, with no clear treatment algorithm. We present a 12-year-old girl with significant posterior C1-C2 distraction and resultant ligamentous injury after a motor vehicle collision who was treated with a halo vest for 3 months. At 8-month follow-up, follow-up magnetic resonance imaging demonstrated complete ligamentous healing without instability on dynamic radiographs, and at 18-month follow-up, the patient made a full recovery.
In some pediatric patients with isolated posterior ligamentous injury, as long as anatomic alignment can be achieved with halo-vest application, a fusion may be avoided.
小儿上颈椎创伤性不稳定、寰枕脱位和骨折的文献相对较少，也没有明确的治疗方案。我们报告了 1 例 12 岁女孩，因机动车事故导致 C1-C2 后脱位和相应的韧带损伤，采用 halo 背心治疗 3 个月。8 个月随访时，磁共振成像显示完全韧带愈合，动力位片未见不稳定，18 个月随访时，患者完全康复。
对于一些小儿患者，只要 halo-vest 应用能够恢复解剖对位，就可以避免融合。对于孤立性后韧带损伤，可避免融合。
