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Tiến sĩ Wills là thường trú, Khoa Chỉnh hình và Phục hồi chức năng, Đại học Wisconsin, Madison, WI. Tiến sĩ Dormans Trưởng Phẫu thuật chỉnh hình, Bệnh viện Nhi Philadelphia, Philadelphia, PA, và giáo sư về phẫu thuật chỉnh hình, Đại học học Y khoa Pennsylvania, Philadelphia. Không ai trong số các tác giả sau đây hoặc các phòng ban | Nontraumatic Upper Cervical Spine Instability in Children Brian P. D. Wills MD John P. Dormans MD Dr. Wills is Resident Department of Orthopedics and Rehabilitation University of Wisconsin Madison WI. Dr. Dormans is Chief of Orthopaedic Surgery The Children s Hospital of Philadelphia Philadelphia PA and Professor of Orthopaedic Surgery University of Pennsylvania School of Medicine Philadelphia. None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article Dr. Wills and Dr. Dormans. Reprint requests Dr. Dormans The Children s Hospital of Philadelphia Second Floor Wood Building 34th and Civic Center Boulevard Philadelphia PA 19104. J Am Acad Orthop Surg 2006 14 233-245 Copyright 2006 by the American Academy of Orthopaedic Surgeons. Abstract The upper cervical spine begins at the base of the occiput continues caudally to the C2-C3 disk space and includes the occipitoatlantal and atlantoaxial joints. Nontraumatic upper cervical spine instability can result from abnormal development of osseous or ligamentous structures or from gradually increasing ligamentous laxity associated with connective tissue disorders. Such instability can lead to compression of the spinal cord during movement of the cervical spine. Establishing a correct diagnosis includes performing a thorough physical examination as well as evaluating radiographic relationships and measurements. Appropriate management of syndromes associated with instability of the upper cervical spine includes preventive care and recommendations for sports participation. Surgical treatment for the upper cervical spine includes a posterior surgical approach used for instability and the use of rigid plate implants wiring and bone graft materials to achieve a solid spinal fusion. The upper cervical spine runs from the occiput to the C2-C3 disk space and includes