A 6-year experience of 100 cases of pediatric bony craniovertebral junction abnormalities: treatment and outcomes

The authors studied 100 consecutive cases of pediatric bony craniovertebral junction abnormalities operated between 2001 and 2006. The pathologies were developmental (n = 86), traumatic (n = 10) and tuberculous (n = 4). Surgical procedures included transoral decompression (n = 59), occipitocervical fusion (OCF, n = 69), C(1)-C(2) fusion (n = 22), occiput-C(2) wiring (n = 5), and posterior fossa decompression (n = 5). Implants for OCF included contoured stainless steel rods (n = 47), titanium lateral mass screws and plates (n = 16) and steel wires (n = 5). Adequate bone fusion was observed in all patients with OCF at a mean follow-up of 16.5 months, irrespective of the type of implant used for posterior fixation. Good neurological outcome was observed even in poor-grade patients. No significant effect on the curvature or growth of the spine was observed at follow-up.