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A 4-year-old child with multilevel spinal injury including atlantooccipital and atlantoaxial dislocation, and thoracic spinal fractures was managed nonoperatively with no significant sequelae from the cervical injuries, but persistent paraplegia from the associated thoracic spinal fractures. Although treatment guidelines cannot be established with the result of one case, we propose an algorithm for treatment of such a rare and severe situation.
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Violas et al. (2006) studied this question.
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