Failure Of Cervical Bracket In The Treatment Of Atlantoaxial Rotational Subluxation In Children

Background: Atlantoaxial rotatory subluxation often occurs in children.It usually shows that the sudden tilt of the head and the pain on one side of the neck can not be relieved.At present,the disease is still mainly treated conservatively,and most patients can generally alleviate their symptoms after a period of Cervical bracket support wearing treatment,and a small number of patients are not ideal for the treatment effect of neck support,following up treatment is required.Objective: To explore the common possible causes of failure of Philadelphia collar in the treatment of atlantoaxial rotational subluxation（AARS）in children.Methods: From January 2017 to may 2021,a total of 43 successful and failed patients with Philadelphia collar were studied retrospectively.Through statistical analysis,whether there were significant differences between the two groups in gender,age,time of initial treatment,history of upper sensation and history of trauma.Results: There were significant differences in age,initial treatment time and trauma history between the two groups（P < 0.05）.Compared with the successful group,the failure group was older（8.07 ± 2.97 years）,the initial treatment interval was longer [7（0.3,12）],and the proportion of severe trauma to the head and neck was greater（47.6%）,but there was no significant difference in upper sensory history and gender between the two groups（P > 0.05）.Conclusion: For the treatment of atlantoaxial rotatory subluxation in children,the factors of age,onset time and trauma history should be comprehensively considered.When the patient is older,the neck is seriously injured and the course of disease lasts for a long time,it is suggested to give up the treatment of neck support and use other treatment methods.