Concerns regarding the long-term effects of certain spinal surgeries in young children may have been put to rest by a team of researchers, including pediatric neurosurgeon Dr. Richard C.E. Anderson from The Pediatric Neurosurgery Center and The Spine Hospital at the Neurological Institute of New York.
When the bones that join the head and neck are misaligned or malformed, the spine may become unstable. This misalignment and/or malformation of the bones can be caused by traumatic injury, Down syndrome, or other genetic factors, with physical trauma being the most common.
In many of these cases, surgery is necessary. If surgery is needed, the neurosurgeon has the option to use rigid internal fixation, such as screws and rods, to securely hold the bones together until the bones fuse and become stable.
This rigid internal fixation is different than the semi-rigid wires that have been used in the past, and allows much faster healing and return to activity. These neck surgeries include occipitocervical (OC) fusion and atlantoaxial (AA) fusion:
Occipitocervical fusion is performed when the bones that join the head and neck are unstable. Atlantoaxial fusion is performed when the first two bones at the top of the spine are not correctly aligned and are unstable.
There has been concern about the long-term effects of OC and AA fusion in young children, since their spines are still developing. In fact, the upper part of the spine, or cervical spine, does not fully develop biomechanically until children reach 9 or 10 years of age.
To address these concerns, Dr. Anderson set his sights on researching the long-term effects of OC and AA fusions with rigid internal fixation in children. As the lead investigator of the study, Dr. Anderson collaborated with researchers at nine Children’s Hospitals around the country to evaluate 40 young children for at least 3 years following OC or AA fusion with rigid internal fixation.
They published their findings in a recent article in the Journal of Neurosurgery: Pediatrics. Dr. Anderson and colleagues demonstrated that the majority of the children who underwent either OC or AA fusion with rigid internal fixations continued to have good alignment and continued growth of the cervical spine post-surgery.
This study was the first to provide long-term outcome data on children who underwent OC and AA fusions with rigid internal fixation. These findings will hopefully put to rest some concerns regarding how the spine will develop after these types of surgeries.
Read the entire Journal of Neurosurgery: Pediatrics article here.