Background: Craniovertebral junction (CVJ) diseases pose a unique challenge to the surgeon owing to its complex anatomy and bio-mechanical characteristics. CVJ not only performs majority of the cervical flexion, extension, and axial rotation but also accommodates key vascular and neural structures. Hence, it is not surprising that it may present with myriad clinical and radiological features. However, there is extremely limited number of papers in the literature focusing on pediatric CVJ diseases in children younger than 5 years. Objective: The aim of this paper is to highlight the surgical management of CVJ diseases in children <5 years of age. Material and Methods: A retrospective chart review of all pediatric patients of CVJ anomalies <5 years of age, treated in our department from September 2015 to January 2024 was carried out. Preoperative and postoperative clinical, radiological, surgical data, and outcomes were analyzed in detail. Results: A total of 23 patients, <5 years of age were included for the analysis. The youngest child in the series is 11 months old. All patients underwent a rigid screw placement by standard posterior approach. 20/23 showed improvement in their neurological outcome following surgery. There was no mortality or instrumentation failure noted in this series. Conclusion: We describe the largest series of rigid screw instrumentation for CVJ anomalies in children <5 years of age. Careful preoperative assessment helps to determine the type and size of screw which are feasible and safe.
Mohanty et al. (Thu,) studied this question.