Cervical cord decompression and posterior cervical immobilization following anterior C1-C2 subluxation in a patient with MPS type IV (morquio syndrome) : A team approach.

We report a 23 month old gril who presented with right hemiparesis after falling for 6 months. She was also diagnosed with mucopolysaccharidosis type IV (Morquio syndrome) with C1-C2 subluxation. Anesthesia was uneventful after inhalation induction, manual in-line stabilization, intubation, external fixation of the cervical spine, followed by prone position and manual assisted ventilation. Postoperative pain was relieved using a tramadol infusion.