Improvise, adapt and overcome-challenges in management of pediatric congenital atlantoaxial dislocation

Salunke, Pravin; Karthigeyan, Madhivanan; Sahoo, Sushanta K.; Sunil, N

doi:10.1016/j.clineuro.2018.05.024

Cited by 14 publications

(4 citation statements)

References 25 publications

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“…However, in patients with congenital CVJ instability, the anatomic orientation of these C1-C2 lateral facet joints is the major determinant of disease progression. [ 2 4 6 8 ] In these, the C1-C2 joints may be congenitally oblique which over a period give rise to progressive slippage of the C1 over C2 and the treatment therefore, aims at their multiplanar remodelling with fixation. Though this treatment is well established, its major downside has been the cervical spine movement limitation.…”

Section: Discussionmentioning

confidence: 99%

“…For instance, while the trauma, degenerative, and inflammatory diseases are its common causes in the western nations, congenital craniovertebral junction (CVJ) anomalies with an underlying C1-C2 facet joint deformity remain the usual reason in the Asian continent. [ 4 5 6 ] Regardless of the etiology, the most common operation performed for AAD has been the CVJ fusion. [ 4 5 6 ] Although this treatment method has been time tested with excellent reported outcomes, one of its important disadvantages is neck movement restriction, a matter of concern from the patients’ perspective.…”

Section: Introductionmentioning

confidence: 99%

“…[ 4 5 6 ] Regardless of the etiology, the most common operation performed for AAD has been the CVJ fusion. [ 4 5 6 ] Although this treatment method has been time tested with excellent reported outcomes, one of its important disadvantages is neck movement restriction, a matter of concern from the patients’ perspective. Thus, an artificial C1-C2 joint prosthesis that overwhelms this specific drawback, yet simultaneously stabilizes the CVJ region is likely to be a boon for the AAD patients.…”

Section: Introductionmentioning

confidence: 99%

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C1-C2 arthroplasty for craniovertebral junction instability: A preliminary proof of concept in human cadavers

Karthigeyan

Salunke

Kodigudla

et al. 2022

J Craniovert Jun Spine

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Background: The atlantoaxial complex contributes to significant neck movements, especially the axial rotation. Its instability is currently treated with various C1-C2 fusion techniques. This however, considerably hampers the neck movements and affects the quality of life; a C1-C2 motion preserving arthroplasty could potentially overcome this drawback. Objectives: We evaluate the range of motion (ROM) of lateral C1-C2 artificial joints in cadaveric models. Materials and Methods: This is an in vitro cadaveric biomechanical study. After C1-C2 arthroplasty through a posterior approach, the C1-C2 ROM was tested in 4 fresh-frozen human cadaveric specimens, before and after destabilization. Results: The mean axial rotation demonstrated after the placement of C1-C2 joint implants was 15.46 degrees on the right and 16.03 degrees on the left side; the prosthesis provided stability, with 46% of the baseline C1-C2 axial rotation on either side. The ROM achieved in the other axes was less compared with that of intact specimens. To initiate rotation, a higher moment of 1.5 Nm was required in the presence of joint implants compared to 0.5 NM in unimplanted specimens. Conclusions: In our preliminary ROM evaluation, the C1-C2 arthroplasty appears to be stable and provides about half of the range of atlantoaxial rotation. It has the potential for joint motion preservation in the treatment of atlantoaxial instability resulting from lateral C1-C2 joint pathologies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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C1-C2 arthroplasty for craniovertebral junction instability: A preliminary proof of concept in human cadavers

Karthigeyan

Salunke

Kodigudla

et al. 2022

J Craniovert Jun Spine

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“…This technique has also been improved over time. From bed traction [27] to halo-gravity traction [28] , we were led to progressive traction by halo-cast or halo-vest.…”

Section: Discussionmentioning

confidence: 99%

Cranio-cervical decompression associated with non-instrumented occipito-C2 fusion in children with mucopolysaccharidoses: Report of twenty-one cases

Zairi¹,

Msakni²,

Mohseni³

et al. 2022

North American Spine Society Journal (NASSJ)

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Displaced odontoid synchondrosis fracture with C1-2 dysjunction in an 18-month-old child: challenges and solutions

et al. 2020

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Improvise, adapt and overcome-challenges in management of pediatric congenital atlantoaxial dislocation

Cited by 14 publications

References 25 publications

C1-C2 arthroplasty for craniovertebral junction instability: A preliminary proof of concept in human cadavers

C1-C2 arthroplasty for craniovertebral junction instability: A preliminary proof of concept in human cadavers

Cranio-cervical decompression associated with non-instrumented occipito-C2 fusion in children with mucopolysaccharidoses: Report of twenty-one cases

Displaced odontoid synchondrosis fracture with C1-2 dysjunction in an 18-month-old child: challenges and solutions

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