Case Reports
Autofusion of the Cervical Spine in 2 Children Following Open Biopsy of Langerhans Cell Histiocytosis
Am J Orthop. 2007 August;36(8):E124-E126
Author and Disclosure Information
Sumeet Garg, MD, Harish Hosalkar, MD, and John P. Dormans, MD
Dr. Garg is a Resident in Orthopaedic Surgery, Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri.
Dr. Hosalkar is a Research Fellow, The Children's Hospital of Philadelphia, Pennsylvania; and Dr. Dormans is Chief of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Pennsylvania, and Professor of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.
Abstract not available. Introduction provided instead.
Spontaneous interbody and spinous process fusion are known sequelae of chronic granulomatous disease. In particular, spinal tuberculosis frequently leads to the development of spontaneous fusion. Prior series have reported rates of osseous fusion in spinal tuberculosis from 29% to 73%.1-4 Spontaneous fusion of the cervical spine has also been noted following treatment of traumatic injuries with halo traction.5-8 In general, these are short-segment fusions of diseased or injured spinal levels and do not limit cervical spine range of motion to an extent that affects normal daily activities.
An extensive search of the MEDLINE database did not reveal any reports in the English language of spontaneous fusion of the cervical spine following open biopsy. All combinations of the terms fusion and spine with biopsy, histiocytosis, and langerhans were reviewed. In the course of conducting long-term follow-up of Langerhans cell histiocytosis of the spine in children, 2 children who had open biopsy of the cervical spine presented at 5 and 6 years of follow-up with spontaneous fusion: one in the anterior elements and the other in the posterior elements.9 Patients were informed that data concerning their cases would be submitted for publication.