{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:46:59Z","timestamp":1787755619350,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 4-year-old boy with a history of posterior fossa ependymoma resection and radiation treatment developed postlaminectomy kyphosis at the occipito-cervical junction. Cervical radiographs showed 46\u00b0 kyphosis between C2 and C4. A 3-stage surgical approach was done: halo-gravity traction, anterior C2 to C4 fusion with a fibular allograft, and posterior occiput-C4 instrumented fusion. Halo traction reduced kyphosis by over 50%. At 1-year follow-up, the patient showed stable fixation and successful fusion with modest limitation in cervical motion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The approach effectively corrected the deformity and successfully achieved fusion despite previous radiation treatment and bone deficiency in a very young, skeletally immature patient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.26.00022","type":"journal-article","created":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:01:34Z","timestamp":1772737294000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Anterior Fibular Graft and Posterior Fusion for Proximal Cervical Kyphosis Following Resection of Posterior Fossa Ependymoma"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7566-6980","authenticated-orcid":false,"given":"Hans K.","family":"Nugraha","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4001-7173","authenticated-orcid":false,"given":"Nathan R.","family":"Graden","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9118-5607","authenticated-orcid":false,"given":"Jeremy L.","family":"Fogelson","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony A.","family":"Stans","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1]]},"reference":[{"issue":"5","key":"bib1-20260305","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1227\/01.NEU.0000367721.73220.C9","article-title":"Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients","volume":"66","author":"McGirt","year":"2010","journal-title":"Neurosurgery."},{"issue":"1","key":"bib2-20260305","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s41984-025-00372-2","article-title":"Laminoplasty vs laminectomy in the surgical management of spinal intradural extramedullary tumors","volume":"40","author":"Singh","year":"2025","journal-title":"Egypt J Neurosurg."},{"issue":"4","key":"bib3-20260305","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1097\/00007632-199702150-00019","article-title":"Spinal column deformity and instability after lumbar or thoracolumbar laminectomy for intraspinal tumors in children and young adults","volume":"22","author":"Papagelopoulos","year":"1997","journal-title":"Spine (Phila Pa 1976)."},{"key":"bib4-20260305","doi-asserted-by":"crossref","first-page":"223","DOI":"10.2106\/00004623-196547020-00001","article-title":"Orthopaedic aspects of intraspinal tumors in infants and children","volume":"47","author":"Tachdjian","year":"1965","journal-title":"J Bone Joint Surg Am."},{"issue":"8","key":"bib5-20260305","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1007\/s00586-024-08260-3","article-title":"Cervical kyphosis after posterior cervical laminectomy with and without fusion","volume":"33","author":"Jentzsch","year":"2024","journal-title":"Eur Spine 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J."},{"issue":"2","key":"bib9-20260305","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s11060-021-03915-3","article-title":"Focused versus conventional radiotherapy in spinal oncology: is there any difference in fusion rates and pseudoarthrosis?","volume":"156","author":"Akinduro","year":"2022","journal-title":"J Neurooncol."},{"issue":"6","key":"bib10-20260305","doi-asserted-by":"crossref","first-page":"597","DOI":"10.3340\/jkns.2016.59.6.597","article-title":"The effect of perioperative radiation therapy on spinal bone fusion following spine tumor surgery","volume":"59","author":"Kim","year":"2016","journal-title":"J Korean Neurosurg Soc."},{"key":"bib11-20260305","doi-asserted-by":"crossref","first-page":"100129","DOI":"10.1016\/j.jposna.2024.100129","article-title":"Pediatric Halo use: indications, application, and potential complications","volume":"9","author":"Bauer","year":"2024","journal-title":"J Pediatr Soc North Am."},{"issue":"4","key":"bib12-20260305","doi-asserted-by":"crossref","first-page":"384","DOI":"10.3171\/2019.10.PEDS19513","article-title":"Halo-gravity traction for the treatment of pediatric cervical spine disorders","volume":"25","author":"Verhofste","year":"2020","journal-title":"J Neurosurg Pediatr."},{"issue":"1","key":"bib13-20260305","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/BF00346604","article-title":"Biomechanical studies of transthoracic vertebral body replacement with autologous bone grafts (fibula and rib)","volume":"19","author":"Kaden","year":"1996","journal-title":"Neurosurg Rev."},{"issue":"2","key":"bib14-20260305","doi-asserted-by":"crossref","first-page":"e140","DOI":"10.1097\/BPO.0000000000000691","article-title":"Allograft bone use in pediatric subaxial cervical spine fusions","volume":"37","author":"Murphy","year":"2017","journal-title":"J Pediatr Orthop."},{"issue":"354","key":"bib15-20260305","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/00003086-199809000-00023","article-title":"Postlaminectomy and postirradiation kyphosis in children and adolescents","author":"Otsuka","year":"1998","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib16-20260305","doi-asserted-by":"crossref","first-page":"101216","DOI":"10.1016\/j.semss.2025.101216","article-title":"Traditional and enabling methods for spinal instrumentation","volume":"37","author":"Nugraha","year":"2025","journal-title":"Semin Spine Surg."}],"container-title":["JBJS Case 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