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Douglas L. Brockmeyer, W. Jerry Oakes, Curtis Rozzelle, James Johnston, Brandon G. Rocque, Richard C. E. Anderson, Neil Feldstein, Jonathan Martin, Gerald F. Tuite, Luis Rodriguez, Nicholas Wetjen, Phillip Aldana, Dave Pincus, Phillip Storm, Mark R. Proctor and Sean Lew

TO THE EDITOR: In his article, 3 Dr. Atul Goel examines the underlying cause and treatment of Chiari malformation Type I (CM-I) in 65 patients at his institution in Mumbai, India (Goel A: Is atlantoaxial instability the cause of Chiari malformation? Outcome analysis of 65 patients treated by atlantoaxial fixation. J Neurosurg Spine 22:116–127, February 2015). All were treated with a surgical technique to fuse the atlas and axis without foramen magnum decompression or intradural exploration. Sixtythree of the patients had favorable outcomes, 1 failed to

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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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Stephen L. Reintjes, Ernest K. Amankwah, Luis F. Rodriguez, Carolyn C. Carey and Gerald F. Tuite

to fusion rates in patients less than 18 years of age who had undergone PCF, with or without inclusion of the occiput. Our primary objective was to determine the relative fusion rates using allograft compared with autologous bone graft, while also considering the effect of other study variables. Methods A literature search was performed using PubMed for English-language articles with the keywords “allograft,” “autograft,” “graft,” “atlantoaxial,” “occipito-cervical fusion,” “cervical instability,” “C1–2 instability,” “os odontoideum,” and “fusion.” The