{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T08:30:45Z","timestamp":1781080245763,"version":"3.54.1"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:p>Unstable spinal injuries in the neonate pose particular challenges in the clinical and radiographic assessment as well as the surgical stabilization of the spine. In this report, the authors present the unfortunate case of a 3-week-old infant who suffered a severe subaxial cervical fracture dislocation with spinal cord injury that occurred as a result of nonaccidental trauma. Imaging demonstrated severe distraction at C5\u20136 and near-complete spinal cord transection resulting in quadri-paresis. Open surgical reduction was performed with noninstrumented posterior fusion augmented with split rib autograft and recombinant human bone morphogenetic protein-2. Postoperative imaging demonstrated progressive bony fusion at 2 months, and clinical examination findings progressed to a motor examination classification of ASIA C. At 2 years, the fusion mass is stable and cervical alignment is maintained. The patient remains flaccid in the bilateral lower extremities, but has movement with some dexterity in both hands. Follow-up MRI shows severe spinal cord injury with evidence of bilateral C-5 nerve root avulsions. This case represents the first report of spinal fusion in an infant of less than 1 month of age. Given the extreme young age of the patient, the diagnostic challenges as well as the mechanical and technical considerations of surgical fusion are discussed.<\/jats:p>","DOI":"10.3171\/2015.3.peds13568","type":"journal-article","created":{"date-parts":[[2015,11,27]],"date-time":"2015-11-27T14:58:51Z","timestamp":1448636331000},"page":"353-356","source":"Crossref","is-referenced-by-count":13,"title":["Posterior cervical spinal fusion in a 3-week-old infant with a severe subaxial distraction injury"],"prefix":"10.3171","volume":"17","author":[{"given":"Christopher M.","family":"Holland","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meysam A.","family":"Kebriaei","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospitals and Clinics of Minnesota, St. Paul, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Wrubel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Emory University School of Medicine, Atlanta, Georgia;"},{"name":"Pediatric Neurosurgical Associates, Children\u2019s Healthcare of Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-peds13568","series-title":"World Neurosurg","first-page":"715.e717","article-title":"Occipitocervical fusion in an infant with atlantooccipital dislocation","volume":"78","author":"Benzel","year":"2012"},{"key":"b2-peds13568","series-title":"J Pediatr","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1016\/S0022-3476(74)80022-3","article-title":"Neonatal spinal cord transection secondary to intrauterine hyperextension of the neck in breech presentation","volume":"84","author":"Bresnan","year":"1974"},{"issue":"Suppl 1","key":"b3-peds13568","series-title":"J Spinal Cord Med","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1080\/10790268.2004.11753778","article-title":"Epidemiology of spinal cord injury in children and adolescents","volume":"27","author":"DeVivo","year":"2004"},{"issue":"1 Suppl","key":"b4-peds13568","series-title":"J Neurosurg","first-page":"12","article-title":"Pediatric cervical spine injuries: report of 102 cases and review of the literature","volume":"92","author":"Eleraky","year":"2000"},{"key":"b5-peds13568","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1227\/NEU.0b013e3181f258ba","article-title":"Routine use of recombinant human bone morphogenetic protein-2 in posterior fusions of the pediatric spine: safety profile and efficacy in the early postoperative period","volume":"67","author":"Fahim","year":"2010"},{"key":"b6-peds13568","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3171\/jns.1975.42.2.0179","article-title":"Cervical spine injuries in infants. 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