Indirect decompression for a prior severe C1-2 dislocation causing progressive quadriparesis.

Combined anterior and posterior surgery is frequently chosen for the treatment of prior, severe C1-2 dislocations that occurred during early childhood because of the difficulty in achieving reduction and satisfactory decompression. The authors treated a prior, severe C1-2 dislocation that was causing progressive quadriparesis. The patient was a 14-year-old boy who had suffered a C1-2 fracture-dislocation at 3 years of age and had been treated with a Minerva body jacket cast. The treatment involved posterior C1-2 segmental screw fixation, without direct bone decompression or additional surgery. Satisfactory neural decompression was achieved with the techniques used, and complete bone union was confirmed. The patient showed satisfactory neurological recovery at the 5-year follow-up assessment.