{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:00:29Z","timestamp":1790125229302,"version":"4.0.1"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"12","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,9,21]]},"abstract":"\n BACKGROUND<\/jats:title>\n Cervical spinal cord compression in early infancy is rare and may cause severe neurological deficit. Management is difficult because the immature cranial anatomy limits the safe use of conventional fixation techniques.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n The authors report the case of a 6-week-old infant with flaccid quadriparesis and respiratory compromise, with MRI showing marked canal narrowing and cord compression at C3. Noninvasive traction was considered insufficient and halo fixation unsuitable due to the thin calvarium and open sutures. Gardner-Wells cranial tongs were therefore applied with minimal weight (0.5 kg) and a relative neck hyperextension for 5 days. Traction resulted in radiological decompression and early neurological recovery without complications.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This case suggests that skeletal cranial traction may be used cautiously as a temporary decompressive measure in selected infants when other options are not feasible, although further evidence is required to define its safety and role in this age group.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE26427<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case26427","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:34Z","timestamp":1789516834000},"source":"Crossref","is-referenced-by-count":0,"title":["Are there age limitations for skull traction? Gardner-Wells tongs as a salvage measure in a 6-week-old infant with C3 cervical spinal cord compression: illustrative case"],"prefix":"10.3171","volume":"12","author":[{"given":"Al-Muaayad","family":"Al-Abri","sequence":"first","affiliation":[{"name":"College of Medicine and Health Sciences, Sultan Qaboos University, Muscat"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Al-Ghaithi Jr.","sequence":"additional","affiliation":[{"name":"College of Medicine and Health Sciences, Sultan Qaboos University, Muscat"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmood","family":"Attalah","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sultan Qaboos University Hospital, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Humaid","family":"Al Farii","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sultan Qaboos University Hospital, Muscat, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"suppl 1","key":"bib1","series-title":"J Spinal Cord Med","first-page":"S11","article-title":"Acute evaluation and management of pediatric spinal cord injury","volume":"27","author":"Betz","year":"2004","unstructured":"Betz RRMulcahey MJD\u2019Andrea LPClements DH.Acute evaluation and management of pediatric spinal cord injury. J Spinal Cord Med. 2004;27(suppl 1):S11-S15. doi:10.1080\/10790268.2004.11753779"},{"issue":"2","key":"bib2","series-title":"J Neurosurg","first-page":"179","article-title":"Cervical spine injuries in infants: problems in management","volume":"42","author":"Gaufin","year":"1975","unstructured":"Gaufin LMGoodman SJ.Cervical spine injuries in infants: problems in management. J Neurosurg. 1975;42(2):179-184. doi:10.3171\/jns.1975.42.2.0179"},{"issue":"6","key":"bib3","series-title":"J Neurosurg Pediatr","first-page":"649","article-title":"Development of best practices in the utilization and implementation of pediatric cervical spine traction: a modified Delphi study","volume":"27","author":"Alexiades","year":"2021","unstructured":"Alexiades NGShao BBraga BPDevelopment of best practices in the utilization and implementation of pediatric cervical spine traction: a modified Delphi study. J Neurosurg Pediatr. 2021;27(6):649-660. doi:10.3171\/2020.10.PEDS20778"},{"issue":"4","key":"bib4","series-title":"J Neurosurg Pediatr","first-page":"384","article-title":"Halo-gravity traction for the treatment of pediatric cervical spine \u00addisorders","volume":"25","author":"Verhofste","year":"2019","unstructured":"Verhofste BPGlotzbecker MPBirch CMO\u2019Neill NPHedequist DJ.Halo-gravity traction for the treatment of pediatric cervical spine \u00addisorders. J Neurosurg Pediatr. 2019;25(4):384-393. doi:10.3171\/2019.10.PEDS19513"},{"key":"bib5","article-title":"Cervical traction","author":"Abi-Aad","year":"2025","unstructured":"Abi-Aad KRDerian A.Cervical traction. In: StatPearls [Internet]. StatPearls Publishing; 2025. Accessed August 21, 2026. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470412\/."},{"issue":"6","key":"bib6","series-title":"Oper Neurosurg","first-page":"e454","article-title":"Neonatal halter traction for severe cervical spine deformity: a technical case report with 2-year follow-up","volume":"24","author":"Menger","year":"2023","unstructured":"Menger RPBeauchamp ECAlexiades NSzpilka RTAnderson RC.Neonatal halter traction for severe cervical spine deformity: a technical case report with 2-year follow-up. Oper Neurosurg. 2023;24(6):e454-e457. doi:10.1227\/ons.0000000000000651"},{"key":"bib7","series-title":"Int J Surg Case Rep","first-page":"110638","article-title":"Bridging the gap: Gardner-Wells tongs utilization in pediatric spinal tuberculosis: a case report","volume":"126","author":"Hendriarto","year":"2025","unstructured":"Hendriarto AJuliandri RHartanto BR.Bridging the gap: Gardner-Wells tongs utilization in pediatric spinal tuberculosis: a case report. Int J Surg Case Rep. 2025;126:110638. doi:10.1016\/j.ijscr.2024.110638"},{"issue":"1","key":"bib8","series-title":"J Spine Surg","first-page":"123","article-title":"Efficacy and complications of the use of Gardner-Wells tongs: a systematic review","volume":"4","author":"Saleh","year":"2018","unstructured":"Saleh HYohe NRazi ASaleh A.Efficacy and complications of the use of Gardner-Wells tongs: a systematic review. J Spine Surg. 2018;4(1):123-129. doi:10.21037\/jss.2018.03.03"}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26427.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26427.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26427.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:03:31Z","timestamp":1790121811000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/12\/12\/article-CASE26427.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,21]]},"references-count":8,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.3171\/case26427","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,21]]}}}