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Internal fixation with occipital hooks construct for occipito-cervical arthrodesis. Results in 14 young or small children

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Abstract

Purpose

Evaluation of effectiveness of internal rigid fixation for occipito-cervical fusion with occipital hooks and cervical screws and/or hooks to improve fusion in young or small children with various bone dysplasia or congenital abnormality.

Methods

Fourteen children with mean age of 8.4 years and height and weight below 140 cm and 35 kg, respectively, who underwent occipito-cervical fusion for miscellaneous pathologies reading to stenosis and/or instability were reviewed. The posterior instrumentation consisted of a precontoured titanium plate rod with an occipital fixation by hooks and a vertebral fixation by screws and/or hooks. Eight patients had cervical fixation with C2 pedicle screws. The mean follow-up was 48 months (27–81 months).

Results

Thirteen patients (92.8 %) had a complete fusion and no failure of the fixation was observed. We had two deep wound infections not related to implants.

Conclusion

Instrumentation was technically feasible even in a very young child. Rigid internal fixation in the little children did not increase surgical complications and significantly increased the union rate of occipito-cervical arthrodesis.

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Conflict of interest

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Authors and Affiliations

  1. Department of Pediatric Orthopedics, Hôpital Universitaire Necker Enfants Malades, Université Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, 149 rue de Sèvres, 75743, Paris Cedex 15, France

    Thierry Odent, Rony Bou Ghosn, Jean-Paul Dusabe & Christophe Glorion

  2. INSERM UMR-S 747 Pharmacologie, toxicologie et signalisation cellulaire, Université Paris Descartes-Sorbonne Paris Cité, Paris, France

    Thierry Odent

  3. Service de neurochirurgie pédiatrique, Hôpital Universitaire Necker Enfants Malades, Université Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, 149 rue de Sèvres, 75743, Paris Cedex 15, France

    Michel Zerah

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  1. Thierry Odent
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  2. Rony Bou Ghosn
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  4. Michel Zerah
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  5. Christophe Glorion
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Correspondence to Thierry Odent.

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Odent, T., Bou Ghosn, R., Dusabe, JP. et al. Internal fixation with occipital hooks construct for occipito-cervical arthrodesis. Results in 14 young or small children. Eur Spine J 24, 94–100 (2015). https://doi.org/10.1007/s00586-014-3436-2

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  • DOI: https://doi.org/10.1007/s00586-014-3436-2

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