Pediatric Cervical Spine Surgery

Pediatric cervical spine surgery is linked to the neck portion of the spine of children which is basically the cervical spine. This is a delicate part of the body especially in children, needing special care.

Some children may have abnormalities in this region right from birth (congenital) and some others can develop injuries because of lack of care or even a car accident or some other traumatic incidents. Pediatric cervical spine surgery is an important treatment option in such cases.

Here are the most common reasons to undergo this procedure. Pediatric cervical spine surgery opts in the case of an injury or abnormality of the cervical spine.

As the cervical spine is the most mobile, it is very prone to injuries. The bony structures can press the skull against the upper portion of the spinal cord or the brainstem itself.

This pressure can lead to irreversible damage to the brain, spine problems or even abnormal brain development. In such cases, a pediatric cervical spine surgery can be opted to rectify these causes.

Other than injury other conditions which may be genetic or acquired could also cause irreversible complications related to the cervical spine in children.

Genetic conditions which result in the need for pediatric cervical spine injury include Down’s syndrome, Kippel-Feil syndrome or other congenital abnormalities whereas acquired medical conditions which can damage to cervical spines may include skeletal dystrophy, metabolic dystrophy or rheumatoid arthritis.

Along with undergoing pediatric cervical spine surgery comes potential risks. As the bones and all the organs and structures in children are very delicate, small pediatric cervical spine surgery is a very challenging task.

The surgeon needs to keep in mind the future growth and development of the child. Before going in for such a procedure all the pros and cons of all the available treatment options should be discussed in detail by the parents and the surgeon.

Some of the potential risks associated with pediatric cervical spine surgery may include:

• Risk of cervical spine instability
• Risk of damage to the spine
• Pain which may last long
• In very rare cases, there may be a risk of an incisional hernia
• Risk of damage to the surrounding nerves
• Risk of wound infections
• Risks associated with anesthesia
• Risk of blood clotting (hematoma)

In preparing for the procedure, you must follow your doctor’s orders. As pediatric cervical spine surgery is a high-risk procedure the expectations from it should be clear in the mind of parents of the child.

There is a risk of complications, failure, and even fatality in exceptional cases. In normal conditions one can be sure in most cases that things go well and as predicted. Before suggesting pediatric cervical spine surgery, the doctor will carefully examine the condition of the patient by a three view cervical spine imaging.

He may ask for several imaging tests like MRI (magnetic resonance imaging), CT- Scan (computed tomography) or X-ray imaging. He/she will then weigh down the risks of the surgery and verify that the patient is not under high-risk criteria like there should be no tenderness in the midline cervical and the patient should be capable of verbal communication before surgery.

Read on to learn more about what to expect before, during, and after your procedure. In pediatric cervical spine surgery, the surgeon’s goal is to remove or offset the bony structures or any abnormalities that are causing undue compression of the brainstem or the spinal cord.

This surgery can be a boon to the patients as it prevents chronic pain, deformity and loss of nerve function. The doctor will start the surgery by giving anesthesia (usually general anesthesia) to the patient. Once the patient becomes unconscious, the doctor will approach the spinal cord by making an incision.

To approach the spinal cord or the brainstem three options are available:

• The transoral approach or through the mouth in which a flexible tube with a camera attached at the tip is used (Endoscope).
• The second approach is to make an incision in the neck either in the front or the back
• The third alternative is an incision in the back

During this surgery, any bone structures or small pieces of bones that are pressing on the delicate portions of the cervical spine of the child are removed as far as possible.

If the spine of the child is unstable due to the removal of the bones, the surgeon has the choice of inserting plates, screws or bone grafts for support. These grafts can originate from another part of the child’s body or from donated bone.

If you do not understand your pediatric cervical spine surgery results, consult with your doctor. After the procedure, the pressure to brain and spinal cord is reduced and thus the risk of neurologic damage reduces to a great extent.

In the patients who had chronic pain due to any injury or structural anomaly, the pain is reduced. As the procedure is risky, the patient may face several complications like cervical spine instability or hematoma.

In the case of spine instability, the doctor may need to graft a support. In some cases, the expected results may remain unmet.