Changes in cervical spine curvature in pediatric patients following occipitocervical fusion

Abstract

Objective: The study aims to assess changes in cervical spine curvature following occipitocervical fusion (OCF) in the pediatric population. Methods: In a retrospective study, the angle of sagittal curvature and whole cervical spine alignment were determined in the preoperative, immediate postoperative, and follow-up radiographs in 14 patients (<20 years of age) who underwent OCF for developmental atlantoaxial instability between 1995 and 2006. At follow-up, the mean angle of sagittal curvature showed a statistically significant increase from 22+/-10.1° immediately following surgery to 35.9±18^° at follow-up (p = 0.001). Six patients had exaggerated lordosis (defined as >10° increase in the angle of sagittal curvature). The sagittal curvature angle did not show any worsening in seven patients following removal of the implant. Conclusions: OCF in the pediatric population can result in an increase in the lordotic curvature of the cervical spine that might stabilize following removal of the metal implant within a year of surgery.