{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:12:19Z","timestamp":1785327139340,"version":"3.55.0"},"reference-count":16,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nTraumatic atlanto-occipital dislocation is an unstable injury of the craniocervical junction. For pediatric patients, surgical arthrodesis of the occipitocervical junction is the recommended management. While having a high success rate for stabilization, the fusion comes with obvious morbidity of limitation in cervical spine flexion, extension, and rotation. An alternative is external immobilization with a conventional halo.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nWe describe the case of a 10-year-old boy who was treated successfully for traumatic AOD with a noninvasive pinless halo. Following initial brain trauma management, we immobilized the craniocervical junction with a pinless halo after reducing the atlanto-occipital dislocation. The pinless halo was kept on at all times for the next 3 months. The craniocervical junction alignment was monitored with weekly cervical spine X-rays and CT craniocervical junction on day 15th<\/jats:sup>, day 30th<\/jats:sup>, and day 70th<\/jats:sup>. A follow-up MRI C-spine 3 months from presentation confirmed resolution of the soft-tissue injury and the pinless halo was removed. Dynamic cervical spine X-rays revealed satisfactory alignment in both flexion and extension views. The patient has been followed up for 2 years postinjury and no issues were identified.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nNoninvasive pinless halo is a potential treatment option for traumatic pediatric atlanto-occipital dislocation. This should be considered bearing in mind multiple factors including age and weight of the patient, severity of the atlanto-occipital dislocation (Grade I vs. Grade II and incomplete vs. complete), concomitant skull and scalp injury, and patient\u2019s ability to tolerate the halo. It is vital to emphasize that this necessitates close clinicoradiological monitoring.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_17_2022","type":"journal-article","created":{"date-parts":[[2022,5,27]],"date-time":"2022-05-27T11:35:30Z","timestamp":1653651330000},"page":"222","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Management of traumatic atlanto-occipital dislocation in a 10-year-old with noninvasive halo immobilization: A case report"],"prefix":"10.25259","volume":"13","author":[{"given":"Himanshu","family":"Shekhar","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedics, NHS Tayside, Ninewells Hospital, Dundee, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Mancuso-Marcello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Emelifeonwu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Gallo","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurosurgery, Birmingham Children\u2019s Hospital, Birmingham Women\u2019s and Children\u2019s NHS Foundation Trust, Birmingham, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drahoslav","family":"Sokol","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurosurgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jothy","family":"Kandasamy","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurosurgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrasekaran","family":"Kaliaperumal","sequence":"additional","affiliation":[{"name":"Department of Paediatric Neurosurgery, NHS Lothian, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2022,5,27]]},"reference":[{"key":"10.25259\/SNI_17_2022\/ref-1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00381-020-04680-w","article-title":"Traumatic atlanto-occipital dislocation in children: Is external immobilization an option?","volume":"37","author":"Abel","year":"2021","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI_17_2022\/ref-2","first-page":"1","article-title":"Failure of the condyle-C1 interval method to diagnose atlanto-occipital dislocation in the presence of an associated atlanto-axial dislocation: A case 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