Gallie technique in the treatment of odontoid fracture in pediatric: A case report
Year: 2025
Type: article
Study design: Case Report
Abstract: INTRODUCTION: Pediatric cervical spine injuries (CSI) account for 60-80 % of all pediatric spine injuries and remains a challenge due to the difference in spinal anatomy compared to adults. There are currently no standardized method of diagnosis and treatment for CSI in children, hence identification and management remain challenging for orthopaedic surgeons. CASE PRESENTATION: a 11-year-old girl present with weakness on right upper and lower limb due to hyperflexion injury after her father accidentally fell on her neck. Initial radiology workup showed normal bony alignments and led to the misdiagnosis of Guillain-Barre Syndrome. However, further CT and MRI workup revealed odontoid fracture compromising the spinal canal, which caused anterior cord syndrome. She was managed by Modified Gallie procedure, which involves passing a sublaminar wire in C1-C2 and using the resected part of C2 from the subsequent decompression as an onlay type graft. Her condition was stable post-operatively and 3-months follow up showed improved motor and sensory function in ASIA Score. Patient had even returned to school and regained mobilization using a walker. DISCUSSION: Upper cervical injuries in younger patients are common due to their anatomy and flexibility allowing immediate self-reduction post dislocation, which may cause the initial normal radiography. Modified Gallie procedure and decompression was selected as the treatment to alleviate the need of additional bone graft. CONCLUSION: Cervical spine injury in children is a rare but challenging entity, where successful management requires an understanding of pediatric anatomical differences and the specific patterns of pathologies that frequently occur.
Authors: Yudha Mathan Sakti, Arief T. Dian, Karisa Kartika Sukotjo, Fuad Dheni Musthofa, Saeful Anwar, Pandhu Al Afghani Harlan
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,090
OpenAlex ID: W4408564751