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Clinical Analysis of Radiologic Measurements in Patients with Basilar Invagination.
- Source :
-
World neurosurgery [World Neurosurg] 2019 Nov; Vol. 131, pp. e108-e115. Date of Electronic Publication: 2019 Jul 16. - Publication Year :
- 2019
-
Abstract
- Objective: To investigate correlations between radiologic measurements and clinical outcomes in patients with basilar invagination (BI).<br />Methods: The medical records and radiologic data of 46 patients (27 women) who had undergone posterior atlantoaxial fusion or occipitocervical fusion for BI from January 2010 to June 2018 were retrospectively analyzed. Patients under 15 years old or with a polytraumatic, tumorous, or infectious pathology were excluded. The modified Ranawat method (MRM) and the Redlund-Johnell method (RJM) were used to obtain radiographic measurements of basilar invagination preoperatively, subacute postoperatively, and at 3-month and last follow-up. Visual analogue scale, Neck Disability Index, and Japanese Orthopedic Association (JOA) scores were also assessed. Correlations between MRM and RJM measurements and clinical outcomes were evaluated.<br />Results: Mean age of patients was 59.9 ± 16.5 years, mean body mass index was 23.5 ± 4.6 kg/m <superscript>2</superscript> , and mean follow-up was 37.9 ± 23.8 months. Postoperative radiologic measurements increased about 36% of preoperative radiologic measurements. Subsidence at the C1-2 joint occurred in most patients at 3 months postoperatively, but clinical outcomes did not deteriorate. JOA scores were linearly correlated with percentage increases in both radiologic measurements subacute postoperatively (P < 0.05), but this significance was not maintained until the last follow-up. Occipital numbness and neuralgia were most common postoperative complications. One case of neurovascular injury and 3 cases of postoperative dysphagia occurred postoperatively.<br />Conclusions: The subacute postoperative neurological outcomes of BI patients are significantly related to the amount of vertical reduction.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Arthritis, Rheumatoid surgery
Atlanto-Axial Joint surgery
Atlanto-Occipital Joint surgery
Female
Foramen Magnum
Humans
Male
Middle Aged
Musculoskeletal Abnormalities surgery
Odontoid Process
Prolapse
Retrospective Studies
Spinal Diseases surgery
Spine abnormalities
Spondylosis surgery
Treatment Outcome
Atlanto-Axial Joint diagnostic imaging
Atlanto-Occipital Joint diagnostic imaging
Spinal Diseases diagnostic imaging
Spinal Fusion
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 131
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 31323410
- Full Text :
- https://doi.org/10.1016/j.wneu.2019.07.080