Absorbable anterior cervical plate for corpectomy and fusion in a 2-year-old child with neurofibromatosis

Technical note

Zvi Lidar M.D., Shlomi Constantini M.D., M.Sc., Gilad J. Regev M.D. and Khalil Salame M.D.
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  • Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Postlaminectomy cervical kyphosis is one of the most challenging entities in spine surgery. Correction of this deformity usually requires anterior fusion with plating and a strut graft or interbody cage and posterior fusion with screws and rods. The situation is more complicated in the young child because fusion may affect future growth of the cervical spine. There is also a paucity of adequate instrumentation for the small bony structures. Some authors have reported utilization of absorbable cervical plates for fusion in pediatric patients with favorable results.

The authors present a modified surgical technique that was used for circumferential fusion in a 2-year-old girl with cervical kyphosis and recurrent neurofibroma. Anterior fusion was performed using an autologous rib graft and an absorbable cervical plate. This was followed by posterior fusion using rib bone and cables. Previous reports on the use of absorbable cervical plates are reviewed and the advantages of the current technique are discussed.

Abbreviations used in this paper:ACDF = anterior cervical discectomy and fusion; NF1 = neurofibromatosis Type 1.

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Contributor Notes

Address correspondence to: Khalil Salame, M.D., Department of Neurosurgery, Tel Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, Israel 64239. email: salame@tasmc.health.gov.il.

Please include this information when citing this paper: DOI: 10.3171/2011.12.PEDS11264.

  • 1

    Cattell HS, & Clark GL Jr: Cervical kyphosis and instability following multiple laminectomies in children. J Bone Joint Surg Am 49:713720, 1967

    • Search Google Scholar
    • Export Citation
  • 2

    de Jonge T, , Slullitel H, , Dubousset J, , Miladi L, , Wicart P, & Illés T: Late-onset spinal deformities in children treated by laminectomy and radiation therapy for malignant tumors. Eur Spin J 14:765771, 2005

    • Search Google Scholar
    • Export Citation
  • 3

    Dickerman RD, , Morgan JT, & Mittler M: Circumferential cervical spine surgery in an 18-month-old female with traumatic disruption of the odontoid and C3 vertebrae. Case report. Pediatr Neurosurg 41:8892, 2005

    • Search Google Scholar
    • Export Citation
  • 4

    Dogan S, , Safavi-Abbasi S, , Theodore N, , Horn E, , Rekate HL, & Sonntag VKH: Pediatric subaxial cervical spine injuries: origins, management, and outcome in 51 patients. Neurosurg Focus 20:1 E1, 2006

    • Search Google Scholar
    • Export Citation
  • 5

    Franco A, , Nina P, , Arpino L, & Torelli G: Use of resorbable implants for symptomatic cervical spondylosis: experience on 16 consecutive patients. J Neurosurg Sci 51:169175, 2007

    • Search Google Scholar
    • Export Citation
  • 6

    Hedequist D, , Hresko T, & Proctor M: Modern cervical spine instrumentation in children. Spine (Phila Pa 1976) 33:379383, 2008

  • 7

    Lonstein JE: Post-laminectomy kyphosis. Clin Orthop Relat Res 128 93100, 1977

  • 8

    McGirt MJ, , Constantini S, & Jallo GI: Correlation of a preoperative grading scale with progressive spinal deformity following surgery for intramedullary spinal cord tumors in children. Clinical article. J Neurosurg Pediatr 2:277281, 2008

    • Search Google Scholar
    • Export Citation
  • 9

    Nabhan A, , Ishak B, , Steimer O, , Zimmer A, , Pitzen T, & Steudel WI, : Comparison of bioresorbable and titanium plates in cervical spinal fusion: early radiologic and clinical results. J Spinal Disord Tech 22:155161, 2009

    • Search Google Scholar
    • Export Citation
  • 10

    Ozer E, , Yucesoy K, & Kalemci O: Temporary anterior cervical plating in a child with traumatic cervical ligamentous instability. Pediatr Neurosurg 41:269271, 2005

    • Search Google Scholar
    • Export Citation
  • 11

    Patel NB, , Hazzard MA, , Ackerman LL, & Horn EM: Circumferential fixation with craniofacial miniplates for a cervical spine injury in a child. Case report. J Neurosurg Pediatr 4:429433, 2009

    • Search Google Scholar
    • Export Citation
  • 12

    Peterson HA, Iatrogenic spinal deformities. Weinstein SL: The Pediatric Spine: Principles and Practice New York, Raven Press, 1994. 651664

    • Search Google Scholar
    • Export Citation
  • 13

    Ruf M, & Harms J: Pedicle screws in 1- and 2-year-old children: technique, complications, and effect on further growth. Spine (Phila Pa 1976) 27:E460E466, 2002

    • Search Google Scholar
    • Export Citation
  • 14

    Sahim N, Neurocutaneous syndromes. Kliegman RM, , Santon BF, & St. Geme JW III, : Nelson Textbook of Pediatrics ed 19 Philadelphia, Elsevier Saunders, 2011. 20462048

    • Search Google Scholar
    • Export Citation
  • 15

    Schultz KD Jr, , Petronio J, , Haid RW, , Rodts GE, , Erwood SC, & Alexander J, : Pediatric occipitocervical arthrodesis. A review of current options and early evaluation of rigid internal fixation techniques. Pediatr Neurosurg 33:169181, 2000

    • Search Google Scholar
    • Export Citation
  • 16

    Shacked I, , Ram Z, & Hadani M: The anterior cervical approach for traumatic injuries to the cervical spine in children. Clin Orthop Relat Res 292 144150, 1993

    • Search Google Scholar
    • Export Citation
  • 17

    Sohn MJ, , Park HC, , Park HS, , Kim JJ, & Kim EY: Anterior cervical corpectomy and fusion using miniplate and screws in a 7-year-old child with eosinophilic granuloma of the cervical spine. Spine (Phila Pa 1976) 26:11931196, 2001

    • Search Google Scholar
    • Export Citation
  • 18

    Vaccaro AR, , Carrino JA, , Venger BH, , Albert T, , Kelleher PM, & Hilibrand A, : Use of bioabsorbable anterior cervical plate in the treatment of cervical degenerative and traumatic disc disruption. J Neurosurg 97:4 Suppl 473480, 2002

    • Search Google Scholar
    • Export Citation
  • 19

    Winter RB, & Moe JH: The results of spinal arthrodesis for congenital spinal deformity in patients younger than five years old. J Bone Joint Surg Am 64:419432, 1982

    • Search Google Scholar
    • Export Citation
  • 20

    Yao KC, , McGirt MJ, , Chaichana KL, , Constantini S, & Jallo GI: Risk factors for progressive spinal deformity following resection of intramedullary spinal cord tumors in children: an analysis of 161 consecutive cases. J Neurosurg 107:6 Suppl 463468, 2007

    • Search Google Scholar
    • Export Citation

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