Long-term impact of atlantoaxial arthrodesis on the pediatric cervical spine

Development of postoperative malalignment of the lower cervical spine and impaired growth of the spinal canal at Cl and C2 levels are common after atlantoaxial arthrodesis in children. Postoperative malalignment diminishes during the follow-up period possibly due to remodeling of the pediatric cervical spine, although remodeling of the spinal canal diameter cannot be expected, suggesting the importance of anatomical reduction before or at the time of surgery.