The Effect of Atlantoaxial Stabilization on Juvenile Idiopathic Scoliosis Involving Chiari Malformation and Syrinx

Abstract

Idiopathic scoliosis (IS) is frequently asSociated with Chiari malformation (CM) and syringomyelia, conditions thought to share a common underlying cause: Atlantoaxial instability. Atlantoaxial stabilization has recently emerged as a novel treatment option. A 4-year-old girl presented with progressive scoliosis (Cobb angle of 28.6 degrees), neck pain, CM, and syringomyelia. The patient was diagnosed with central or axial atlantoaxial instability and underwent C1-C2 fixation. Postoperatively, she experienced significant relief from neck pain. Follow-ups demonstrated progressive syrinx reduction, while X-rays revealed a Cobb angle decrease to 21 degrees in 18 months. This case highlights the potential of atlantoaxial stabilization to halt scoliosis progression in IS patients with CM and syringomyelia. Unlike traditional multisegmental stabilization, C1-C2 fixation offers a minimally invasive approach and preserves spinal mobility in growth-age patients. Atlantoaxial instability should be considered in IS cases with CM and syringomyelia. Atlantoaxial stabilization alone may provide effective treatment with favorable clinical and radiological outcomes.