Hemi-atlas resection by combined approach: case report, literature review, and technical note

Childs Nerv Syst. 2022 Nov;38(11):2239-2244. doi: 10.1007/s00381-022-05583-8. Epub 2022 Jun 10.

Abstract

Purpose: Hemivertebra within the craniovertebral junction is a rare but complex spinal deformity. Torticollis caused by hemi-atlas is extremely rare. There is no consensus on the treatment of these patients. We present our experience with one case of hemi-atlas excision and torticollis correction via a combined anterior-posterior surgical approach and short-segment fixation.

Methods: An 11-year-old girl with progressive torticollis due to hemi-atlas underwent surgery consisting of combined anterior-posterior hemivertebra resection and instrumentation and had a follow up of 20 months. Pre- and postoperative radiographic features, as well as clinical outcomes, were evaluated.

Results: The patient had complete recovery of torticollis at a 20-month follow-up. Radiographs showed favorable deformity correction, well-balanced coronal and sagittal alignment, and solid bony fusion.

Conclusion: For patients with congenital cervical hemivertebra within the craniovertebral junction, combined anterior-posterior hemivertebra resection with instrumentation allows for satisfactory deformity correction and good cosmetic improvement.

Keywords: Anterior–posterior approach; Hemi-atlas; Hemivertebra resection; Torticollis.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / surgery
  • Radiography
  • Retrospective Studies
  • Scoliosis* / diagnostic imaging
  • Spinal Fusion*
  • Torticollis*
  • Treatment Outcome