Instrumentation of the paediatric cervical spine
CITATION: Dunn, R. N. & Botha, A. H. 2014. Instrumentation of the paediatric cervical spine. South African Orthopaedic Journal, 13(1):44-49.
The original publication is available at http://www.scielo.org.za
BACKGROUND: Paediatric cervical fusion surgery is challenging. Traditional techniques such as external stabilisation, onlay fusions and wiring techniques resulted in unsatisfactory outcomes due to inferior biomechanical stability. METHODS: A retrospective review was performed of paediatric patients who underwent instrumented cervical fusion surgery under 16 years of age. Fusion rates, blood loss, levels fused, theatre time, technique and complications were assessed. RESULTS: An average of 2.5 levels was fused, with an estimated blood loss of 428 ml and surgical duration of 159 min. Anterior procedures had an average of one level fused with blood loss of 117 ml and surgical duration of 98 min. Posterior procedures had an average number of 1.9 levels fused, blood loss of 306 ml and surgical time of 131 min. Combined procedures had an average of 5.5 levels fused, blood loss 810 ml and surgical duration of 241 min. Four surgery-related complications were encountered. These consisted of dural leaks and wound sepsis which were all treated effectively. All patients achieved radiological fusion. CONCLUSION: The use of modern segmental spinal instrumentation in the paediatric cervical spine is a viable option. Although the study sample was small we are able to demonstrate that no major surgical complications were encountered due to the use of adult cervical spinal instrumentation techniques in the paediatric group.
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