• Kamal Hamoud and Janan Abbas.
• Department of Orthopedic Surgery, Poriya Medical Center, Tiberias, Lower Galilee, Israel; Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel; Zefat Academic College, Zefat, Israel. Electronic address: k_hamoud@yahoo.com.
• Injury. 2014 Nov 1;45(11):1791-5.

BackgroundReported surgical treatment for injuries and instabilities of the paediatric cervical spine most commonly involves posterior fusion with internal fixation, usually posterior wiring.PurposeTo present a new simple technique of stabilization without fusion of the upper cervical spine of young children.Study DesignA technical report.MethodsDetailed description of the surgical procedure carried out for stabilizing an unstable flexion-distraction injury in a 23 month-old toddler, with severe head injury and pneumothorax is presented.ResultsA rare unstable flexion-distraction injury in the upper cervical spine of a toddler was successfully treated with a posterior Number 2 Vicryl (polyglactin 910) suture fixation, with good healing of the ligaments and endplates, without fusion. Preservation of motion was achieved without obvious instability at 63 months post-surgery.ConclusionsIn selected cases of cervical spine injuries in the young paediatric population, a limited approach to the injured spinal segments and simple stabilization using suitable degradable sutures, can provide sufficient stability until healing occurs.Advantagesfusion is avoided, growth disturbances are prevented and spinal motion maintained.Copyright © 2014 Elsevier Ltd. All rights reserved.

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