Pediatric Cervical Spine Surgery

Overview

Mayo Clinic in Minnesota is an innovative leader in the treatment of cervical spine abnormalities in children. In Mayo's unique system, experienced and highly trained teams of specialists work together to provide expertise and the most-current treatment options for pediatric patients with this uncommon condition, including minimally invasive and endoscopic surgery.

In pediatric cervical spine injuries, congenital (present at birth) bone abnormalities may result in the compression of the skull on the brainstem or upper cervical spinal cord (the bones in the neck). This pressure may destabilize the spine. The condition is corrected through surgery to remove the bony structures that are causing the skull to press against the brainstem or spinal cord, which prevents the possibility of long-term loss of neurological function, deformity and chronic pain.

At Mayo, specialists from Pediatric Neurosurgery, Orthopedics and Physical Medicine and Rehabilitation work together to identify cervical spine abnormalities in children and provide the most appropriate treatment for each patient.

Mayo Clinic ranks in the top 10 children's hospitals for Neurology and Neurosurgery.

Evaluation

Pediatric cervical spine injuries and abnormalities are uncommon in the general population, but occur frequently in populations with Down syndrome, various forms of dwarfism, and Klippel-Feil syndrome. Most cervical spine injuries are caused by some form of congenital abnormality that leads to abnormal development and instability of the spine.

At Mayo, patients benefit from specialists' familiarity and experience with this uncommon condition. Mayo specialists may identify genetic abnormalities while reviewing radiographs, CT scans and magnetic resonance images (MRI) that have been ordered for unrelated problems.

Types of Pediatric Cervical Spine Surgery

The goal of treatment for cervical spine abnormalities is to halt or reverse the progression of signs and symptoms. Mayo Clinic specialists may use specific measurements of the bony relationship of the skull on the spine to determine whether to recommend surgery and, if so, the most appropriate surgery to remove bony structures pressing on the spinal cord. Surgical options include:

• A transoral approach (through the mouth) is used to remove bony structures pressing on the front of the spinal cord or brainstem.
• A decompression is achieved through the removal of small pieces of bone pressing on the spinal cord and brainstem at the back of the skull and spine. The treatment of Chiari malformation is a form of cervical spine surgery that involves decompression.
• If instability may be caused by the removal of the bony structures pressing on the spinal cord and brainstem, bone grafts may be inserted to help bone fuse across the void formed by bone removal.

If specialists identify cervical spine abnormalities but the patient shows no symptoms of compression — neurological dysfunction, unstable deformity, or pain — no treatment may be needed.

Treatment Team

Pediatric cervical spine abnormalities and injuries are treated by specialists in the departments of Pediatric Neurosurgery, Orthopedic Surgery and Physical Medicine and Rehabilitation, who work together to provide the most appropriate treatment for each patient.