A novel surgical management for pediatric patients with irreducible atlantoaxial dislocation: Transoral intraarticular cage distraction and fusion with C-JAWS staple fixation

BackgroundCurrently, irreducible atlantoaxial dislocation (IAAD) can be treated by a single transoral approach in one stage to reduce surgical injuries to patients. However, the widely used fixation devices are not suitable for pediatric patients because of larger profile of devices.ObjectiveThe purpose of this study is to report the preliminary clinical outcomes of a novel surgical technique by transoral intraarticular cage distraction and fusion with C-JAWS staple fixation for pediatric patients with IAAD.MethodsFrom June 2011 to June 2014, eight pediatric patients with IAAD were enrolled and treated by this technique in our department. Patients' clinical data were retrospectively analyzed, including neurological status, clinical symptoms, reduction, bone fusion, and complications.ResultsThe surgeries were successfully performed in all patients without injuries to spinal cord, nerve and blood vessel. Clinical symptomatic relief was presented on all 8 patients (100%). Satisfactory reduction was indicated by significant decrease of atlanto-dental interval postoperatively (P