World neurosurgery · 2023
The Relationship Between Cervical Sagittal Balance and Type of Atlantoaxial Dislocation Secondary to Os Odontoideum.
СтатьяНазвание и аннотация: Перевод в очереди
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Wu Ji, Li Yang, Chen Fei, Wang Haibin, Ni Bin, Yang Haisong, Guo Qunfeng
Аннотация
OBJECTIVE: To analyze the effect of cervical sagittal balance on the direction and type of atlantoaxial dislocation.
METHODS: Data of 55 patients seen at our hospital for atlantoaxial instability/dislocation caused by os odontoideum were reviewed. Radiographic variables, including T1 slope (T1S), C1-C2 angle, C2-C7 angle, C1-C2 sagittal vertical axis (SVA), C2-C7 SVA, and atlanto-dens interval (ADI), were measured preoperatively. Patients were divided into three groups according to ADI: anterior atlantoaxial dislocation, atlantoaxial instability, and posterior atlantoaxial dislocation. Differences within and between groups in radiographic variables and relationships between the investigated variables were analyzed.
RESULTS: ADI was strongly negatively associated with C1-C2 angle (r = -0.805, P < 0.05); whereas ADI had a medium-strength positive relationship with C2-C7 angle (r = 0.425, P < 0.05) and a medium-strength negative relationship with C2-C7 SVA (r = -0.411, P < 0.05). However, ADI was not significantly correlated with T1 slope (r = -0.092, P > 0.05).
CONCLUSIONS: The type and direction of atlantoaxial dislocation is closely associated with cervical sagittal balance. C2-C7 SVA is an important factor in assessing the direction of atlantoaxial subluxation secondary to os odontoideum. ADI decreases with increasing C2-C7 SVA. The larger the C2-C7 SVA, the more likely the atlantoaxial dislocation is to be posterior.
METHODS: Data of 55 patients seen at our hospital for atlantoaxial instability/dislocation caused by os odontoideum were reviewed. Radiographic variables, including T1 slope (T1S), C1-C2 angle, C2-C7 angle, C1-C2 sagittal vertical axis (SVA), C2-C7 SVA, and atlanto-dens interval (ADI), were measured preoperatively. Patients were divided into three groups according to ADI: anterior atlantoaxial dislocation, atlantoaxial instability, and posterior atlantoaxial dislocation. Differences within and between groups in radiographic variables and relationships between the investigated variables were analyzed.
RESULTS: ADI was strongly negatively associated with C1-C2 angle (r = -0.805, P < 0.05); whereas ADI had a medium-strength positive relationship with C2-C7 angle (r = 0.425, P < 0.05) and a medium-strength negative relationship with C2-C7 SVA (r = -0.411, P < 0.05). However, ADI was not significantly correlated with T1 slope (r = -0.092, P > 0.05).
CONCLUSIONS: The type and direction of atlantoaxial dislocation is closely associated with cervical sagittal balance. C2-C7 SVA is an important factor in assessing the direction of atlantoaxial subluxation secondary to os odontoideum. ADI decreases with increasing C2-C7 SVA. The larger the C2-C7 SVA, the more likely the atlantoaxial dislocation is to be posterior.