Surgical treatment of craniocervical junction pathology has evolved considerably in recent years with the implementation of short fixation techniques rather than long occipito-cervical fixation (sub-axial). It is often difficult and sometimes misleading to determine the particular bone and vascular features (high riding vertebral artery, for instance) using only the conventional images in three...

The authors present a unique case of an 11-year-old child with spontaneous fusion of his occiput to C1–C2 following traction,manipulative reduction, and halo immobilization for refractory atlantoaxial rotatory fixation. The child initially presented with torticollis, neck pain, and headaches and underwent numerous chiropractor manipulations over 9 months with alleviation of his neck pain and he...

sustain traumatic brain injuries due to blunt force trauma. Cervical spinal injury should be suspected in any trauma patient with loss of consciousness. All of the following patients should undergo a radiographic search for a cervical spinal injury: patients who present awake with neck pain or tenderness, patients with a neurologic deficit, patients who have sustained a traumatic brain injury, ...

Achondroplasia is the most common condition associated with disproportionate short stature. Substantial information is available concerning the natural history and anticipatory health supervision needs in children with this dwarfing disorder. Most children with achondroplasia have delayed motor milestones, problems with persistent or recurrent middle-ear dysfunction, and bowing of the lower leg...

OBJECTIVES To describe the clinical and neuroradiological features of basilar impression in patients with osteogenesis imperfecta type IV. METHODS Four patients with basilar impression were ascertained in a population study of osteogenesis imperfecta. All four had detailed clinical and neuroradiological examination with both CT and MRI of the craniocervical junction and posterior fossa struct...

Sleep apnea is a rare but well-known clinical feature of disorders of the craniocervical junction. It may be obstructive or central in nature, and rarely presents without other neurological symptoms. We report the cases of two children, presenting with isolated central sleep apnea leading to a diagnosis of type I Chiari malformation. Surgical treatment resulted in a dramatic improvement in resp...

OBJECT Occipital condyle fractures (OCFs) are rare injuries and their treatment remains controversial. Several classification systems have been proposed, first by Anderson and Montesano and more recently by Tuli and colleagues and Hanson and associates, who sought to stratify these fractures in a manner that would guide treatment that has typically ranged from semirigid collar immobilization to...