Brockmeyer DL, et al. - Authors in a retrospective analysis of a multicenter cohort ascertained the factors predictive of posterior atlantoaxial fusion failure in pediatric patients. They retrospectively recorded the clinical and surgical details for all patients who underwent posterior atlantoaxial fusion at 7 pediatric spine centres from 1995 to 2014. Nonetheless, findings suggested high posterior pediatric atlantoaxial fusion success rates, Down syndrome was a risk factor that significantly predicted the possibility of surgical failure.