Case ReportA new technique for stabilization of injuries at C2-C3 in young children

BackgroundReported surgical treatment for injuries and instabilities of the paediatric cervical spine most commonly involves posterior fusion with internal fixation, usually posterior wiring.PurposeTo present a new simple technique of stabilization without fusion of the upper cervical spine of young children.Study designA technical report.MethodsDetailed description of the surgical procedure carried out for stabilizing an unstable flexion-distraction injury in a 23 month-old toddler, with severe head injury and pneumothorax is presented.ResultsA rare unstable flexion-distraction injury in the upper cervical spine of a toddler was successfully treated with a posterior Number 2 Vicryl (polyglactin 910) suture fixation, with good healing of the ligaments and endplates, without fusion. Preservation of motion was achieved without obvious instability at 63 months post-surgery.ConclusionsIn selected cases of cervical spine injuries in the young paediatric population, a limited approach to the injured spinal segments and simple stabilization using suitable degradable sutures, can provide sufficient stability until healing occurs. Advantages: fusion is avoided, growth disturbances are prevented and spinal motion maintained.