Changes in cervical spine curvature in pediatric patients following occipitocervical fusion

Objective  The study aims to assess changes in cervical spine curvature following occipitocervical fusion (OCF) in the pediatric population. Methods  In a retrospective study, the angle of sagittal curvature and whole cervical spine alignment were determined in the preoperative, immediate postoperative, and follow-up radiographs in 14 patients (<20 years of age) who underwent OCF for developmental atlantoaxial instability between 1995 and 2006. At follow-up, the mean angle of sagittal curvature showed a statistically significant increase from 22+/−10.1° immediately following surgery to 35.9+/−18° at follow-up (p = 0.001). Six patients had exaggerated lordosis (defined as >10° increase in the angle of sagittal curvature). The sagittal curvature angle did not show any worsening in seven patients following removal of the implant. Conclusions  OCF in the pediatric population can result in an increase in the lordotic curvature of the cervical spine that might stabilize following removal of the metal implant within a year of surgery.