The effect of atlantoaxial stabilization on juvenile idiopathic scoliosis involving Chiari malformation and syrinx

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°), 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° 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.