Are there age limitations for skull traction? Gardner-Wells tongs as a salvage measure in a 6-week-old infant with C3 cervical spinal cord compression: illustrative case.

BACKGROUND: Cervical spinal cord compression in early infancy is rare and may cause severe neurological deficit. Management is difficult because the immature cranial anatomy limits the safe use of conventional fixation techniques. OBSERVATIONS: The authors report the case of a 6-week-old infant with flaccid quadriparesis and respiratory compromise, with MRI showing marked canal narrowing and cord compression at C3. Noninvasive traction was considered insufficient and halo fixation unsuitable due to the thin calvarium and open sutures. Gardner-Wells cranial tongs were therefore applied with minimal weight (0.5 kg) and a relative neck hyperextension for 5 days. Traction resulted in radiological decompression and early neurological recovery without complications. LESSONS: This case suggests that skeletal cranial traction may be used cautiously as a temporary decompressive measure in selected infants when other options are not feasible, although further evidence is required to define its safety and role in this age group. https://thejns.org/doi/10.3171/CASE26427.