Cervical Spine Range of Motion in Children With Posterior Occipitocervical Arthrodesis

This prospective study compared cervical spine (c-spine) range of motion (ROM) in children with posterior occipitocervical arthrodesis to a control group of healthy participants. Cervical spine ROM is likely be altered after fusion. However, the extent to which posterior occipitocervical arthrodesis affects ROM in the c-spine of children has not yet been established. Furthermore, there are conflicting reports on this topic in the literature. To the best of our knowledge, no study has specifically addressed the effect of posterior occipitocervical arthrodesis on c-spine ROM in children. In this study, c-spine ROM of 15 patients who underwent posterior occipitocervical arthrodesis for upper c-spine instability was evaluated and compared with 15 healthy age-matched children. We used the CROM Goniometer (Performance Attainment Associates, St Paul, MN) to measure c-spine flexion, extension, lateral bending, and axial rotation. Student t test was used to evaluate the study results. Cervical spine ROM was significantly decreased in children with posterior occipitocervical arthrodesis compared with controls (P < 0.05). Axial rotation was the most affected movement, decreasing by an average of 30 degrees in each direction, flexion and extension each decreased by 13 degrees, and lateral bending decreased by approximately 7 degrees in each direction. Posterior occipitocervical arthrodesis decreases c-spine ROM in children compared with healthy controls.