Eur Spine J (2018) 27:1199–1200 https://doi.org/10.1007/s00586-017-5338-6 REVIEWER’S COMMENT Expert’s comment concerning Grand Rounds case entitled “Treatment of cervical subaxial injury in the very young child” by Z. Özbek et al. (Eur Spine J; 2017. doi:10.1007/ s00586‑017‑5316‑z) Paul F. Heini Received: 1 October 2017 / Accepted: 4 October 2017 / Published online: 13 October 2017 © Springer-Verlag GmbH Germany 2017 This comment does focus on the surgical aspects: surgery in small children is particular, but specialized anesthesia also allows complex interventions in this patient group. Closed reduction of the spinal dislocation might be achieved, but in cases with a complete disruption of the ligamentous complex the spine does not show any intrinsic stability. Transient fixation of the head with sandbags can be useful. The surgi - cal approach follows the same principles as in adults. The challenges start with the bone. The skeleton is very small, the anatomical structures are tiny. The bone is very soft. On the other hand, in children the head is dispropor- tionately big and heavy, the mechanical demands are high, contrasting problems need to be solved. The surgical strategy for the treatment of subaxial CS In a regular frequency, case reports on this very sad topic are disruptions with a combined approach
European Spine Journal – Springer Journals
Published: Oct 13, 2017
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