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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Yoshiki Takeoka (Department of Orthopaedic Surgery Kobe University Graduate School of Medicine) Kenichiro Kakutani (Department of Orthopaedic Surgery Kobe University Graduate School of Medicine) Hiroshi Miyamoto (Department of Orthopaedic Surgery National Hospital Organization Kobe Medical Center) Teppei Suzuki (Department of Orthopaedic Surgery National Hospital Organization Kobe Medical Center) Takashi Yurube (Department of Orthopaedic Surgery Kobe University Graduate School of Medicine) Izumi Komoto (Department of Orthopaedic Surgery Kobe Children’s Hospital) Masao Ryu (Department of Orthopaedic Surgery National Hospital Organization Kobe Medical Center) Shinichi Satsuma (Department of Orthopaedic Surgery Kobe Children’s Hospital) Koki Uno (Department of Orthopaedic Surgery National Hospital Organization Kobe Medical Center)
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제4호
발행연도
2021.12
수록면
778 - 785 (8page)
DOI
10.14245/ns.2142720.360

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초록· 키워드

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Objective: To clarify the complications of posterior fusion for atlantoaxial instability (AAI) in children with Down syndrome and to discuss the significance of surgical intervention. Methods: Twenty pediatric patients with Down syndrome underwent posterior fusion for AAI between February 2000 and September 2018 (age, 6.1±1.9 years). C1?2 or C1?3 fusion and occipitocervical fusion were performed in 14 and 6 patients, respectively. The past medical history, operation time, estimated blood loss (EBL), duration of Halo vest immobilization, postoperative follow-up period, and intra- and perioperative complications were examined. Results: The operation time was 257.9±55.6 minutes, and the EBL was 101.6±77.9 mL. Complications related to the operation occurred in 6 patients (30.0%). They included 1 major complication (5.0%): hydrocephalus at 3 months postoperatively, possibly related to an intraoperative dural tear. Other surgery-related complications included 3 cases of superficial infections, 1 case of bone graft donor site deep infection, 1 case of C2 pedicle fracture, 1 case of Halo ring dislocation, 1 case of pseudoarthrosis that required revision surgery, and 1 case of temporary neurological deficit after Halo removal at 2 months postoperatively. Complications unrelated to the operation included 2 cases of respiratory infections and 1 case of implant loosening due to a fall at 9 months postoperatively. Conclusion: The complication rate of upper cervical fusion in patients with Down syndrome remained high; however, major complications decreased substantially. Improved intra- and perioperative management facilitates successful surgical intervention for upper cervical instability in pediatric patients with Down syndrome.
#Pediatric Down syndrome #Surgical complication #Atlantoaxial instability #Posterior fusion #Atlantodental interval #Cervical spine

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참고문헌 (35)

참고문헌 신청
Tishler J / 1965 / Dislocation of the atlas in mongolism : preliminary report / Radiology 84:904~906 google schola Martel W / 1966 / Observations on the spine in mongoloidism / Am J Roentgenol Radium Ther Nucl Med 97:630~638 google schola Semine AA / 1978 / Cervical-spine instability in children with Down syndrome(trisomy 21) / J Bone Joint Surg Am 60:649~652 google schola Pueschel SM / 1987 / Atlantoaxial instability in individuals with Down syndrome : epidemiologic, radiographic, and clinical studies / Pediatrics 80:555~560 google schola Segal LS / 1991 / Complications of posterior arthrodesis of the cervical spine in patients who have Down syndrome / J Bone Joint Surg Am 73:1547~1554 google schola

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