Pediatric congenital atlantoaxial dislocation: differences between the irreducible and reducible varieties.

Object: Clinicoradiological differences and outcome following surgery in pediatric patients (< or = 16 years of age) with congenital irreducible atlantoaxial dislocation (IAAD) and reducible atlantoaxial dislocation (RAAD) were analyzed.

Methods: Ninety-six patients (57 with IAAD and 39 with RAAD) were categorized as follows: Grade I, no deficits except hyperreflexia or neck pain (six patients); Grade II, minor deficits but independent for activities of daily living (25); Grade III, partially dependent (30); and Grade IV, totally dependent (35). Patients with RAAD underwent direct posterior fusion, and those with IAAD were treated with transoral decompression and posterior fusion.

Surgical management of remote, isolated type II odontoid fractures with atlantoaxial dislocation causing cervical compressive myelopathy.

Objective: The remote (more than 6 mo after injury) and isolated (not associated with any other cervical spinal fractures) Type II fractures of the odontoid (RI IIO) are unique in being inherently unstable and prone to malunion or nonunion, leading to cervical compressive myelopathy. The present study discusses their surgical management.

Methods: Nineteen patients with RI IIO with atlantoaxial dislocation (AAD) causing compressive myelopathy were treated.