Journal of Craniovertebral Junction and Spine最新文献

{"title":"In spine surgery, compression is not an issue and decompression is not the treatment.","authors":"Atul Goel","doi":"10.4103/jcvjs.jcvjs_200_24","DOIUrl":"10.4103/jcvjs.jcvjs_200_24","url":null,"abstract":"","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"385-387"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile schwannomas of the spine: Diagnostic and surgical considerations of two cases.","authors":"Galal Elsayed, Gabrielle Dykhouse, Weiye Yasen, Ning Lin, John K Park","doi":"10.4103/jcvjs.jcvjs_135_24","DOIUrl":"10.4103/jcvjs.jcvjs_135_24","url":null,"abstract":"<p><p>Mobile schwannomas, or schwann cell tumors, are rare, but their ability to migrate within the spinal canal complicates diagnosis and treatment. We report two cases of mobile schwannomas in the lower thoracic and lumbar spine, both presenting with intermittent low back and leg pain and leg numbness. MRIs revealed cystic masses that shifted positions over time, eventually causing disruptive pain that prompted surgical intervention. Postoperative outcomes were favorable, highlighting the importance of considering tumor mobility in preoperative planning. Mobile schwannomas present diagnostic and surgical challenges. Recognizing the potential for tumor mobility is crucial in developing effective treatment strategies, as it impacts clinical presentation and surgical approach.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"511-514"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of impaired levels with outcomes for cervical fracture dislocation using the Japanese diagnosis procedure combination database.","authors":"Kazuma Doi, Naoki Otani, Norihiko Inoue, Junichi Mizuno, Kiyohide Fushimi, Atsuo Yoshino","doi":"10.4103/jcvjs.jcvjs_127_24","DOIUrl":"10.4103/jcvjs.jcvjs_127_24","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study of data abstracted from the diagnosis procedure combination (DPC) database.</p><p><strong>Objecitives: </strong>The etiology of cervical fracture dislocation (CFD) remains unknown because of the limited clinical investigations that involve approximately 100 individuals. This study investigated the association of CFD-impaired levels with patient outcomes.</p><p><strong>Methods: </strong>This study included 4653 adult patients with a definitive CFD diagnosis from the DPC database. The database consisted of nationwide inpatient data collected from >1000 acute care hospitals in Japan. This DPC database contains information regarding the hospitalization course, such as diagnosis, treatment, medical history, complications, and hospitalization outcomes. We included 866 CFD patients whose impaired levels were specified. We compared the outcomes between the patients whose CFD occurred in the upper cervical levels (\"high\" group) and the intermediate-low levels (\"low\" group). This study determined 121 pairs of patients after one-to-one propensity score matching (PSM). The main outcomes included inhospital death, 30-day mortality, and major complications after admission. The secondary outcomes were the length of hospital stay, discharged home rate, and improvement in Barthel index.</p><p><strong>Results: </strong>No differences in inhospital death and 30-day mortality were found between the high and low groups, even after adjusting for PSM (<i>P</i> > 0.05, respectively). Moreover, this analysis revealed that the high group exhibited a higher incidence of respiratory complications than the low group (37.2% vs. 24.8%; <i>P</i> = 0.0256).</p><p><strong>Conclusions: </strong>This study revealed no difference in mortality but a significantly higher incidence of respiratory complications with high-level CFD compared to low-level CFD.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"433-436"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome.","authors":"Hamzah Alsheikh Soleiman, Mary Solou, Andreas K Demetriades","doi":"10.4103/jcvjs.jcvjs_132_24","DOIUrl":"10.4103/jcvjs.jcvjs_132_24","url":null,"abstract":"<p><strong>Background: </strong>Cauda equina syndrome (CES) is a rare spinal emergency. Paradoxically, in the British NHS, suspected CES requiring an emergency magnetic resonance imaging constitutes one of the commonest reasons for acute referrals to neurosurgery/spine surgery. Further acute referrals also occur with the reverse scenario, when radiological evidence of cauda equina compression is not accompanied by the clinical red flags of the syndrome. The understanding of CES, particularly in cases with radiological compression but lacking clinical symptoms, remains limited. This study aims to explore the incidence and the long-term outcomes of such patients, addressing a significant knowledge gap.</p><p><strong>Methods: </strong>A single-center, retrospective and cohort study was conducted, analyzing suspected CES referrals managed between August 2013 and November 2014. Patients with radiological cauda equina compression but without clinical CES features were identified. A structured questionnaire assessed long-term patient reported outcomes.</p><p><strong>Results: </strong>Out of 344 suspected CES referrals, 38 patients (11%) had radiological CES of degenerative cause without clinical symptoms. From those with radiological cauda equina compression but no features of CES, 14 were assessed for long-term results and the majority still underwent surgery (64%), either emergent (35.7%) or elective (28.6%). The long-term patient reported outcomes of the operated patients revealed that 66.7% were fully ambulant, 77.8% maintained an intact sexual function, and 88.9% were free of urinary symptoms. However, no matter the management, chronic pain persisted in 85.7%.</p><p><strong>Conclusion: </strong>This study highlights the existence of patients who are referred urgently with radiological cauda equina compression but who lack clinical CES symptoms. Despite surgical interventions, chronic pain remains a significant issue. Further research, including multi-centered studies, is warranted to enhance our understanding of this condition and its nuanced subpopulations.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"482-491"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic outcomes and subsidence rate in hyperlordotic versus standard lordotic interbody spacers in patients undergoing anterior cervical discectomy and fusion.","authors":"Rajkishen Narayanan, Nicholas B Pohl, Jonathan Dalton, Yunsoo Lee, Alexa Tomlak, Anthony Labarbiera, Meryem Guler, Emilie Sawicki, Sebastian I Fras, Mark F Kurd, John J Mangan, Ian David Kaye, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Christopher K Kepler, Gregory D Schroeder, Joseph K Lee","doi":"10.4103/jcvjs.jcvjs_116_24","DOIUrl":"10.4103/jcvjs.jcvjs_116_24","url":null,"abstract":"<p><strong>Background: </strong>Anterior cervical discectomy and fusion (ACDF) is a common surgery for patients with degenerative cervical disease and current interbody spacers utilized vary based on material composition, structure, and angle of lordosis. Currently, there is a lack of literature comparing subsidence rates or long-term radiographic outcomes with hyperlordotic and standard lordotic spacers. This study compares long-term radiographic outcomes, subsidence rate, and rate of fusion in patients who underwent ACDF with hyperlordotic or standard interbody placement.</p><p><strong>Materials and methods: </strong>Patients who underwent 1-3-level ACDF with either a standard lordosis or hyperlordotic interbody were included. Standard radiographs were evaluated for C2-7 lordosis (CL), sagittal vertical axis, C2 slope (C2S), T1 slope (T1S), subsidence rate, and fusion.</p><p><strong>Results: </strong>Forty-five patients underwent ACDF with hyperlordotic interbody placement and after a 1:1 propensity match with standard lordotic patients, 90 patients were included. 1-year postoperative radiographs demonstrated the hyperlordotic cohort achieved higher CL (15.3° ± 10.6° vs. 9.58° ± 8.88°; <i>P</i> = 0.007). The change in CL (8.42° ± 9.42° vs. 0.94° ± 8.67°; <i>P</i> < 0.001), change in C2S (-4.02° ± 6.68° vs. -1.11° ± 5.42°; <i>P</i> = 0.026), and change in T1S (3.49° ± 7.30° vs. 0.04° ± 6.86°, <i>P</i> = 0.008) between pre- and postoperative imaging were larger in the hyperlordotic cohort. There was no difference in overall subsidence (<i>P</i> = 0.183) and rate of fusion (<i>P</i> = 0.353) between the cohorts.</p><p><strong>Conclusion: </strong>Hyperlordotic spacer placement in ACDF can provide increased CL compared to standard lordosis spacers, which can be considered for patients requiring restoration or maintenance of CL following ACDF.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"475-481"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unstable thoracolumbar injuries: A bibliometric analysis of the most influential papers.","authors":"Eduardo Cattapan Piovesan, Werner Petry Silva, Alfredo Guiroy, Bruna Zanatta De Freitas, Vinícius Cercena Vargas, Charles Carazzo","doi":"10.4103/jcvjs.jcvjs_43_24","DOIUrl":"10.4103/jcvjs.jcvjs_43_24","url":null,"abstract":"<p><strong>Background: </strong>Bibliometric analyses are a proficient method for understanding the dynamics of publications. Unstable thoracolumbar injuries are a prevalent topic in neurosurgery and orthopedic research.</p><p><strong>Methodology: </strong>Web of Science was searched for the 100 most-cited articles on unstable thoracolumbar injuries. A number of citations, article title, first author's name, year and journal of publication and its impact factor (IF), specialty, affiliation, country of the first author, and type of the article were retrieved.</p><p><strong>Results: </strong>The articles were published in 32 different journals from 1977 to 2020. Spine (38 articles in the top 100 and 3694 citations) was the journal with the greatest number of articles and citations, and the highest number of primary research papers (31 articles, accounting for 2915 citations). The United States was the country with the most articles (45) and citations (4541). The University of California (5 articles, 6 primary research, and 781 citations) was the institution with the highest number of citations, articles, and primary research articles. Orthopedic was the specialty with the most significant number of publications and the most cited (77 articles and 7197 citations). The first author with the greatest number of publications and primary research articles was R. F. McLain (4 articles, being 3 primary research, and 646 citations), while the most cited was A. R. Vaccaro (3 articles and 695 citations). Eighty publications were primary and 20 were secondary research.</p><p><strong>Conclusions: </strong>The unstable thoracolumbar research field is prominent in North America and has been more frequently published in orthopedic journals, after 1995.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"467-474"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of distal peripheral nerve blocks in lumbar radicular pain: A randomized placebo-controlled triple-blinded study.","authors":"Vivek Jha, Gaurav Kumar Sharma, Omeshwar Singh, Jatin Aggarwal","doi":"10.4103/jcvjs.jcvjs_90_24","DOIUrl":"10.4103/jcvjs.jcvjs_90_24","url":null,"abstract":"<p><strong>Context: </strong>Inflamed nerve root leads to mechano-sensitization and upregulation of sodium channels in nerve endings far distal to the site of inflammation, leading to tenderness of these nerve endings. Due to pseudounipolar nature, the blockade of sodium channels at peripheral nerve endings leads to relief in radicular pain.</p><p><strong>Aims: </strong>The aim of this study was to assess the efficacy of bupivacaine in improving pain and straight leg raising test (SLRT), 30 min after injection around tender nerves near the ankle, in patients with unilateral radicular pain.</p><p><strong>Design: </strong>This was a randomized placebo-controlled triple-blinded study.</p><p><strong>Methods: </strong>One hundred patients of single-level lumbar disc prolapse and unilateral radicular pain were randomized into two equal groups. Three nerves (sural nerve, lateral branch of deep peroneal nerve and posterior tibial nerve) were assessed for tenderness around the ankle. Bupivacaine (0.5%) was injected around each tender nerve in the case group whereas equal volume of normal saline was injected in the control group around each tender nerve. Pain Numerical Rating Scale (NRS) and SLRT were checked before and 30 min postinjection. A proportion of patients achieving minimum clinically important difference (MCID) of NRS ≤4 and MCID of SLRT ≥30° were compared.</p><p><strong>Results: </strong>A mean decrease in NRS among cases was from 8.06 ± 1.236 to 3.90 ± 2.013 (<i>P</i> < 0.001) with 78% achieving MCID. A mean decrease in NRS in the control group was from 7.88 ± 1.023 to 7.66 ± 1.171 (<i>P</i> = 0.084), and only 2% of patients achieved MCID. There was a statistically significant improvement in SLR in the case group (40.90°-60.90°, <i>P</i> < 0.001), and 54% showed a clinically significant improvement by crossing MCID threshold. The control group showed nonsignificant improvement in SLRT (38.10°-39.10°, <i>P</i> = 0.351), and only 2% achieved MCID.</p><p><strong>Conclusions: </strong>In single-level lumbar disc prolapse with unilateral radicular pain, injection of bupivacaine 0.5% (a sodium channel blocker) around tender nerves near the ankle provides clinically significant relief in pain and SLRT at 30 min when compared to placebo.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"448-454"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative complications following spinal fusion in idiopathic scoliosis: A review of 825 cases from the German Spine Registry (DWG-register) - Perioperative complications in idiopathic scoliosis.","authors":"Juan Manuel Vinas-Rios, Vincent J Heck, Fatima Azucena Medina-Govea, Mario Alberto Islas-Aguilar, Nikolaus Kernich","doi":"10.4103/jcvjs.jcvjs_129_24","DOIUrl":"10.4103/jcvjs.jcvjs_129_24","url":null,"abstract":"<p><strong>Background: </strong>Overview of the literature: Idiopathic scoliosis (IS) is most commonly developed during adolescence and affects 2%-3% of the population. The overall complication rate for corrective surgeries in adolescent IS patients is described as 6.3%. Perioperative complications include intraoperative blood loss, neurological deficit, and infection, with excessive blood loss being one of the most common. The aim of the study is to evaluate the prevalence of major and minor complications following posterior or anterior fusion for IS.</p><p><strong>Methods: </strong>Retrospective multicenter study of data from the DWG-Register of patients who underwent operative treatment for IS from January 2017 to September 2022. Inclusion criteria: IS, age between 10 and 30 years.</p><p><strong>Results: </strong>In total, 825 IS patients undergoing fusion were identified in the registry; <i>n</i> = 801 (Group 1) did not have operative complications and <i>n</i> = 24 had a complication related to surgical procedure (Group 2); therefore, the complications rate was 2.9%. A 1.3% rate of major complications and 1.6% rate of minor complications were recorded as follows: spinal cord damage <i>n</i> = 2 (8.4%), subfaszial hematoma <i>n</i> = 2 (8.4%), motor dysfunction <i>n</i> = 1 (4.2%), cerebrospinal fluid (CSF)-leakage <i>n</i> = 7 (29.2%), sensory dysfunction <i>n</i> = 6 (25%), bowel/bladder dysfunction <i>n</i> = 1 (4.2%), superficial site infection <i>n</i> = 2 (8.4%), and pulmonary lung atelectasis <i>n</i> = 3 (12.5%). According to the logistic regression model, an odds ratio for pedicel screws versus laminar hooks for hyperkyphosis correction of 3.73 and for Ponte-osteotomy of 11.5 was found.</p><p><strong>Conclusions: </strong>In IS patients treated operatively, the prevalence of nonneurologic postoperative complications following corrective surgery was 1.80% with CSF leak being the leading risk of complication at 0.84.%. These findings should guide surgeons in their intraoperative Dural tear repair particularly osteotomies. Alternate level pedicle-screw placement with laminar hooks leads to higher operation time and more extensive fusion with consequent slightly prevalence in perioperative complications.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"443-447"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantoaxial fixation for treatment of syringobulbia and syringomyelia: Case report and literature review.","authors":"Kaunda Emeka Ibebuike, Oluwamayowa Opara","doi":"10.4103/jcvjs.jcvjs_124_24","DOIUrl":"10.4103/jcvjs.jcvjs_124_24","url":null,"abstract":"<p><p>The shunting system has been generally recognized for the treatment of syringomyelia. However, recent publication has documented the role of atlantoaxial stabilization in the treatment of this condition. The objective is to present a case report highlighting our experience in the management of syringobulbia and syringomyelia in an adult male. We present a 45-year-old male who presented with an inability to walk with associated bladder and bowel symptoms. Neuroradiological studies of the brain and the whole spine revealed an extensive syringomyelia extending from the medulla oblongata to the T12 thoracic spinal level. There was no obvious focal mass lesion or bony lesion, and there were no anatomic features suggestive of Chiari I malformation. A management decision was challenging in this case. Atlantoaxial stabilization was considered based on Atul Goel's philosophy that the basic pathology in syringomyelia is C1/C2 instability, and that treatment is C1-C2 fixation. Intraoperative findings confirmed atlantoaxial instability from the direct bone handling during the procedure. There was immediate postoperative improvement in his motor function, which remained sustained, with free and brisk active mobilization at 3 months follow-up. Neuroimaging performed at 14 month's postsurgery revealed a reduction in the size of the syrinx cavity. This single and first experience of atlantoaxial stabilization for the treatment of syringomyelia in our environment may support the assertion by Goel that atlantoaxial instability is the pathology in syringomyelia, and atlantoaxial fixation should be a therapeutic consideration.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"506-510"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atlantoaxial rotary subluxation in children after trampoline injury: A critical but overlooked diagnosis.","authors":"Vijayanth Kanagaraju, Sri Deepa Kolathupalayam Srinivasan, Sherief Elsayed, Ravi Kumar Ponnappan","doi":"10.4103/jcvjs.jcvjs_154_24","DOIUrl":"10.4103/jcvjs.jcvjs_154_24","url":null,"abstract":"<p><p>Atlanto-axial rotary subluxation (AARS) is rare but recognized as a significant cervical spine injury following a fall or physical impact on the head or neck in children aged 5-15 years. Trampoline use has been increasing among children, as have the trampoline-related injuries (TRI). We present a case series of AARS following trampoline injuries, highlighting clinical presentation, diagnosis, and management, especially in an emergency setting. We report four children with an average age of 8.5 years (range 6-12 years) presented to our hospital emergency service with neck pain and torticollis following a TRI. The diagnosis was confirmed through X-ray and computed tomography imaging, revealing Fielding and Hawkins type 1 AARS. Conservative treatment with analgesics, muscle relaxants, and a cervical collar led to recovery in three cases, while one required halter cervical traction for persistent deformity. All patients recovered completely, with no long-term complications. AARS in children is largely a type 1 injury with a favorable prognosis. Early recognition and management are crucial in preventing complications. The increasing incidence of neck injuries caused by trampoline use in children necessitates strict safety regulations regarding its use.</p>","PeriodicalId":51721,"journal":{"name":"Journal of Craniovertebral Junction and Spine","volume":"15 4","pages":"515-518"},"PeriodicalIF":1.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}