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[Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite].
Zhonghua Wai Ke Za Zhi. 2019 Oct 01; 57(10):63-68.ZW

Abstract

Objective:

To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage.

Methods:

Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospital of Hebei Medical University were retrospective analyzed. There were 15 males and 22 females with age of (42.3±12.3)years (range: 18-69 yars). All the cases had congenital osseous abnormalities, such as assimilation of atlas and abnormal cervical fusion. Anterior tissue was released through posterior route followed by cage implantation into facet joint and occipital-cervical fixation with cantilever technique. The clinical results were evaluated using Japanese Orthopedic Association scale(JOA) and the main radiological measurements including anterior atlantodental interval (ADI),the distance of odontoid tip above Chamberlain line,clivus-canal angle (CCA) and the length of syrinx were collected.The preoperative and postoperative JOA score and radiological measurements were compared by paired t-test.

Results:

The mean JOA score of the patients increased from 10.5 to 14.4 at the one-year follow-up(t=14.3,P=0.00).Complete reduction of AAD and BI was achieved in 34 patients.The mean clivus-canal angle improved from 118.0 degrees preoperative to 143.7 degrees postoperative(t=6.2,P=0.00). Shrinkage of the syrinx was observed 1 week after surgery in 24 patients, and 6 months in 31 patients. Twenty-eight patients achieved bone fusion 6 months after surgery. All the patients achieved bone fusion 12 months after surgery. One-side vertebral artery occlusion was diagnosed in 1 case postoperatively for transient dizziness, and relieved in 2 weeks. Two patients developed moderate neck pain after surgery, and relieved in 1 month. No implant failure, spacer subsidence or infection was observed.

Conclusions:

The treatment of AAD associated with BI using Xuanwu occipital-cervical fusion system from posterior approach in single stage is effective and safe. Cage implantation intraarticularly and fixation with cantilever technique achieve complete reduction in most cases.

Authors+Show Affiliations

Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.Department of Neurosurgery, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy, Beijing 100053, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

31510735

Citation

Duan, W R., et al. "[Reduction of the Atlantoaxial Dislocation Associated With Basilar Invagination Through Single-stage Posterior Approach: Using Xuanwu Occipital-cervical Reduction Surgical Suite]." Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], vol. 57, no. 10, 2019, pp. 63-68.
Duan WR, Liu ZL, Guan J, et al. [Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite]. Zhonghua Wai Ke Za Zhi. 2019;57(10):63-68.
Duan, W. R., Liu, Z. L., Guan, J., Xia, Z. Y., Zhao, X. H., Jian, Q., Lan, H. T., Zhao, Z. M., Jian, F. Z., & Chen, Z. (2019). [Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite]. Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery], 57(10), 63-68. https://doi.org/10.3760/cma.j.issn.0529-5815.2019.10.012
Duan WR, et al. [Reduction of the Atlantoaxial Dislocation Associated With Basilar Invagination Through Single-stage Posterior Approach: Using Xuanwu Occipital-cervical Reduction Surgical Suite]. Zhonghua Wai Ke Za Zhi. 2019 Oct 1;57(10):63-68. PubMed PMID: 31510735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Reduction of the atlantoaxial dislocation associated with basilar invagination through single-stage posterior approach: using Xuanwu occipital-cervical reduction surgical suite]. AU - Duan,W R, AU - Liu,Z L, AU - Guan,J, AU - Xia,Z Y, AU - Zhao,X H, AU - Jian,Q, AU - Lan,H T, AU - Zhao,Z M, AU - Jian,F Z, AU - Chen,Z, PY - 2019/9/13/entrez PY - 2019/9/13/pubmed PY - 2019/10/23/medline KW - Atlanto-axial joint KW - Basilar invagination KW - Dislocation KW - Posterior approach SP - 63 EP - 68 JF - Zhonghua wai ke za zhi [Chinese journal of surgery] JO - Zhonghua Wai Ke Za Zhi VL - 57 IS - 10 N2 - Objective: To examine the effect of posterior reduction in atlantoaxial dislocation (AAD) associated with basilar invagination(BI) using Xuanwu occipital-cervical fusion system in single stage. Methods: Thirty-seven AAD accompanied with BI cases treated at Department of Neurosurgery, Xuanwu Hospital, Capital Medical Universiy and the Second Hospital of Hebei Medical University were retrospective analyzed. There were 15 males and 22 females with age of (42.3±12.3)years (range: 18-69 yars). All the cases had congenital osseous abnormalities, such as assimilation of atlas and abnormal cervical fusion. Anterior tissue was released through posterior route followed by cage implantation into facet joint and occipital-cervical fixation with cantilever technique. The clinical results were evaluated using Japanese Orthopedic Association scale(JOA) and the main radiological measurements including anterior atlantodental interval (ADI),the distance of odontoid tip above Chamberlain line,clivus-canal angle (CCA) and the length of syrinx were collected.The preoperative and postoperative JOA score and radiological measurements were compared by paired t-test. Results: The mean JOA score of the patients increased from 10.5 to 14.4 at the one-year follow-up(t=14.3,P=0.00).Complete reduction of AAD and BI was achieved in 34 patients.The mean clivus-canal angle improved from 118.0 degrees preoperative to 143.7 degrees postoperative(t=6.2,P=0.00). Shrinkage of the syrinx was observed 1 week after surgery in 24 patients, and 6 months in 31 patients. Twenty-eight patients achieved bone fusion 6 months after surgery. All the patients achieved bone fusion 12 months after surgery. One-side vertebral artery occlusion was diagnosed in 1 case postoperatively for transient dizziness, and relieved in 2 weeks. Two patients developed moderate neck pain after surgery, and relieved in 1 month. No implant failure, spacer subsidence or infection was observed. Conclusions: The treatment of AAD associated with BI using Xuanwu occipital-cervical fusion system from posterior approach in single stage is effective and safe. Cage implantation intraarticularly and fixation with cantilever technique achieve complete reduction in most cases. SN - 0529-5815 UR - https://www.unboundmedicine.com/medline/citation/31510735/[Reduction_of_the_atlantoaxial_dislocation_associated_with_basilar_invagination_through_single_stage_posterior_approach:_using_Xuanwu_occipital_cervical_reduction_surgical_suite]_ L2 - https://medlineplus.gov/dislocations.html DB - PRIME DP - Unbound Medicine ER -