Improvise, adapt and overcome-challenges in management of pediatric congenital atlantoaxial dislocation

Pediatric patients have deformed and oblique joints, thereby making complete spondyloptosis, severe vertical dislocation and lateral tilt common in this age group. Though pediatric bones are soft and small, it is possible to achieve multiplanar realignment by drilling and manipulation of C1-2 joints. The realignment and short segment C1-2 fusion in these patients has a good radiological and clinical outcome.