Atlantoaxial rotatory fixation in childhood: a staged management strategy incorporating manipulation under anaesthesia.
Ciaran Scott HillAnouk BorgMuhammad Zubair TahirDominic Nolan Paul ThompsonPublished in: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (2020)
MUA is a safe procedure for AARF where initial conservative measures have failed. MUA followed by immobilisation avoids the need for open surgery in over two thirds of cases. Immobilisation by cervical collar appears equally effective to HBO as an initial management, and so a step-wise approach may be reasonable. Delayed presentation may be a risk factor for relapse and need for open surgery.