Background: The anterior atlantodental interval (AADI) and posterior atlantodental interval (PADI) on X-ray and computed tomography (CT) studies can both be used to gauge the risk and/or presence of neurological compression.
Methods: This retrospective observational study was conducted at a tertiary care center in 116 patients with head injuries additionally warranting routine cervical X-ray and CT examinations.
Results: The AADI averaged 1.36 ± 0.45 mm (X-ray) and 1.393 ± 0.47 mm (CT), while the mean PADI was 18.04 ± 2.44 mm (X-ray), and 18.07 ± 2.43 mm (CT). Notably, 93.96% of the total subjects had AADI below 2 mm. Further, 6.8% of patients with PADI =/<14 mm had no neurological deficits.
Conclusion: No significant differences were observed for X-ray versus CT studies, measuring AADI and PADI. Therefore, X-rays should continue to prove reliable for assessing craniovertebral junction anatomy in emergency settings. Of interest, the normal upper limit of AADI on sagittal CT reconstructions should now be changed to 2 mm from the previously accepted upper limit of 3 mm.
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http://dx.doi.org/10.25259/SNI_679_2021 | DOI Listing |
Oper Neurosurg (Hagerstown)
August 2024
Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, People's Republic of China.
Eur Spine J
June 2024
Department of Orthopedic Surgery, Mayo Clinic, 200 1 St. SW, Rochester, MN, 55905, USA.
Purpose: To determine if C2 pedicle versus pars screw type predicts change in fusion status, C2 screw loosening, cervical alignment, and patient-reported outcomes measures (PROMs) after C2-T2 posterior cervical decompression and fusion (PDCF).
Methods: All adult patients who underwent C2-T2 PCDF for myelopathy or myeloradiculopathy between 2013-2020 were retrospectively identified. Patients were dichotomized by C2 screw type into bilateral C2 pedicle and bilateral C2 pars screw groups.
J Orthop Surg Res
February 2024
Department of Orthopedics, The First Affiliated Hospital of Anhui Medical University, No.218 Jixi Road, Hefei, 230022, Anhui Province, People's Republic of China.
Purpose: The treatment of unstable atlas fractures remains a controversial topic. The study aims at assessing the prognosis and efficacy of osteosynthesis for unstable atlas fractures through a review of the current literature and additionally aims to compare outcomes between the transoral and posterior approaches.
Methods: A systematic review of databases including PubMed, EMBASE, Cochrane, Web of Science, CNKI, and Wanfang was conducted.
Surg Neurol Int
November 2023
Department of Orthopaedics, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.
Background: Craniovertebral junction (CVJ) pathologies include atlantoaxial instability/deformities resulting in myelopathy, respiratory failure, and even death. Here, we describe the indications, preoperative planning, and intra-operative/postoperative complications following surgical management of CVJ anomalies.
Methods: A prospective analysis of 34 patients with CVJ pathology was evaluated between 2015 and 2022.
Cureus
August 2023
Radiodiagnosis, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.
Basilar invagination (BI) and Chiari malformation type I (CM-I) are important anomalies involving the craniovertebral junction (CVJ) involving the skull base and occipitocervical region. The incidence of BI is rare involving < 1% of the general population worldwide. They present with varied and complex clinical-radiological features.
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