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Andrew Jea

SR , Fjeld-Olenec K : Comparison of posterior fossa decompression with and without duraplasty for the surgical treatment of Chiari malformation Type I in pediatric patients: a meta-analysis . J Neurosurg Pediatr 2 : 42 – 49 , 2008 3 Godil SS , Parker SL , Zuckerman SL , Mendenhall SK , Mc-Girt MJ : Accurately measuring outcomes after surgery for adult Chiari I malformation: determining the most valid and responsive instruments . Neurosurgery 72 : 820 – 827 , 2013 4 Goel A : Is atlantoaxial instability the cause of Chiari

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Meng Huang, David D. Gonda, Valentina Briceño, Sandi K. Lam, Thomas G. Luerssen and Andrew Jea

70, M RA NA Extended 4.75 Yes Dysphagia 3 61, F RA Oc-C3 fusion Neutral 2.75 No Prolonged intubation 4 63, F Epidural tumor Oc-C4 fusion Flexed 6.7 Yes Dysphagia persisted 5 69, M RA NA NA 4.6 No Tracheostomy, dysphagia persisted 6 77, F RA, atlantoaxial subluxation Oc-C2 fusion Flexed (−18°) 4.9 Yes Dyspnea resolved after revision, dysphagia persisted 7 78, F Atlantoaxial osteoarthritis, occipitalization of C-1 Oc-C3 fusion Flexed (−14°) NA NA Dysphagia

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Christina Sayama, Caroline Hadley, Gina N. Monaco, Anish Sen, Alison Brayton, Valentina Briceño, Brandon H. Tran, Sheila L. Ryan, Thomas G. Luerssen, Daniel Fulkerson and Andrew Jea

unlimited quantity and immediate availability of rhBMP-2 make it useful in certain pediatric spine applications, although its cost may be prohibitive in some circumstances. Previous studies of pediatric occipitocervical and atlantoaxial constructs had reported much higher fusion rates (around 98% to 100%). 7 , 11 , 13 , 16 In recent comparisons of fusion rates following occcipitocervical and atlantoaxial instrumented fusion using a large clinical series and administrative data sets, Mazur et al. 15 and Hankinson et al., respectively, reported higher rates of fusion

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Christina Sayama, Matthew Willsey, Murali Chintagumpala, Alison Brayton, Valentina Briceño, Sheila L. Ryan, Thomas G. Luerssen, Steven W. Hwang and Andrew Jea

of occipitocervical wound w/ irrigation & debridement & by placement of BMP & new bone graft 24 Morselized cancellous allograft, local autograft, iliac crest harvest 61 No Transverse myelitis resulting in complete thoracic-level paraplegia 14 13 yrs, 5 mos, F H/O severe TBI; progr neuromusc scoliosis T4–lium PIF 12 Morselized cancellous allograft 59 No None 15 10 yrs, 6 mos, M Atlantoaxial instability; os terminale persistens C1–2 PIF 8.4 Morselized cancellous allograft 55 No Superficial wound cellulitis 16 16

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Benjamin C. Kennedy, Randy S. D’Amico, Brett E. Youngerman, Michael M. McDowell, Kristopher G. Hooten, Daniel Couture, Andrew Jea, Jeffrey Leonard, Sean M. Lew, David W. Pincus, Luis Rodriguez, Gerald F. Tuite, Michael L. Diluna, Douglas L. Brockmeyer, Richard C. E. Anderson and Pediatric Craniocervical Society

B oth occipitocervical (OC) and atlantoaxial (AA) instability are common problems encountered by pediatric spine surgeons. There are a wide variety of possible etiologies for pediatric OC and AA instability, including trauma, Down syndrome, os odontoideum, infection, mucopolysaccharidosis, atlantoaxial rotatory subluxation, juvenile rheumatoid arthritis, tumors, spondyloepiphyseal dysplasia, iatrogenic causes, and others. 4 , 13 , 20 , 30 , 32 , 40 It has been shown that trauma is the most common cause of OC and AA instability, with younger children being

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Aditya Vedantam, Daniel Hansen, Valentina Briceño, Alison Brayton and Andrew Jea

craniovertebral junction pathology. The aim of the present study was to perform an assessment of surgical interventions in a series of children with craniovertebral junction pathology, with an emphasis on measuring PROs and HRQOL outcomes. Methods We reviewed all consecutive patients (age ≤ 18 years) who underwent occipitocervical or atlantoaxial fusion performed by the pediatric neurosurgery service at Texas Children's Hospital from 2008 to 2015. This study received approval from the Baylor College of Medicine Institutional Review Board. All patients underwent

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orthosis, 2 with a Minerva brace, and 1 with a halo. Two patients required cervical surgery; an occipital cervical fusion for a type 2 odontoid fracture and one atlantoaxial fusion for atlantoaxial instability was performed. At the follow up appointments, none of the patients were found to have delayed instability based on clinical examination, upright x-rays or flexion-extension x-rays. Conclusion: All isolated OCF are likely stable injuries. Our data suggests all isolated OCF may be treated conservatively with any type of cervical orthosis and minimal follow up

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Guillermo Aldave, Daniel Hansen, Steven W. Hwang, Amee Moreno, Valentina Briceño and Andrew Jea

buckling: a cadaveric study . J Neurosurg Spine 23 : 120 – 127 , 2015 10.3171/2014.11.SPINE14877 31 Sayama C , Hadley C , Monaco GN , Sen A , Brayton A , Briceño V , : The efficacy of routine use of recombinant human bone morphogenetic protein-2 in occipitocervical and atlantoaxial fusions of the pediatric spine: a minimum of 12 months' follow-up with computed tomography . J Neurosurg Pediatr 16 : 14 – 20 , 2015 10.3171/2015.2.PEDS14533 25860982 32 Sayama C , Willsey M , Chintagumpala M , Brayton A , Briceño V , Ryan SL

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Stephen K. Mendenhall, Andrew Huh, Janit Pandya, Vincent Alentado, Karl Balsara, Chang Ho and Andrew Jea

W ith its widespread availability and use, operator independence, quick through-put, and high resolution, CT is often used in the initial evaluation of the pediatric cervical spine after trauma. 15 Asymmetry of the lateral atlantodental interval (LADI) has been reported in healthy adult and pediatric patient populations with or without a history of trauma, both on plain radiographs and CT scans. 2 , 3 , 5 , 9–13 , 17 , 24 However, asymmetry of LADI may also rarely indicate ligamentous injury or atlantoaxial rotatory subluxation, which, if present, could lead to

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Spinal instrumentation in infants, children, and adolescents: a review

JNSPG 75th Anniversary Invited Review Article

Stephen Mendenhall, Dillon Mobasser, Katherine Relyea and Andrew Jea

appeared in Chern JJ, et al: Instrumentation and stabilization of the pediatric spine: technical nuances and age-specific considerations, in Quinones-Hinojosa A (ed): Schmidek & Sweet: Operative Neurosurgical Techniques: Indications, Methods, and Results, ed 6. Philadelphia: Elsevier Saunders, 2012, Vol 1, pp 759–767. C1 lateral mass screw placement may itself carry the risks of vertebral artery injury, but our experience and that of others 53 , 57 , 68 , 139 show that it can be performed safely and be an efficacious part of an atlantoaxial or occipitocervical