Cervical Spine Anomalies in Children

Author

Douglas Brockmeyer, M.D.

Section Editors

Douglas Brockmeyer, M.D.

Dominic Thompson, M.D.

Editor in Chief

Rick Abbott, M.D.

Introduction

Children with nontraumatic cervical spine abnormalities constitute a diverse and challenging group of patients.  The underlying anatomy and pathology for each condition and knowledge of who may or may not benefit from a surgical procedure must be understood.  This chapter contains both general information about cervical spine anomalies and brief outlines to assist in managing specific conditions.

Key Points

• May be responsible for any instability or injury: Congenital anomalies of the cervical spine may be the underlying cause of spinal instability and/or neurological injury in many patients. Careful patient assessment and knowledge of the condition’s natural history is required to determine which patients need operative intervention.
• Use of halos rarely needed: Advances in spinal instrumentation have allowed most patients with unstable spines to be treated with internal fixation without external halo orthoses.
• Knowledge about grafts and other biologics important: Appropriate use of bone graft material and biologics, along with knowledge of their individual properties, is important for success.
• Uniform goal of structural integrity for all treatments: The ultimate goal in managing congenital cervical anomalies is to provide structural support for the spinal column while protecting the neural elements from injury. Achieving this goal with minimal complications and/or morbidity is a significant challenge in the management of these conditions.