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Sequential sagittal alignment changes in the cervical spine after occipitocervical fusion

World Journal of Clinical Cases 2022年第4期10卷 1172-1181页

作者： Ce Zhu Lin-Nan Wang Tai-Yong Chen Li-Li Mao Xi Yang Gan-Jun Feng Li-Min Liu Yue-Ming Song Department of Orthopedics Surgery and Orthopedics Research Institute West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Orthopedics Surgery The Second Affiliated Hospital of Zunyi Medical UniversityZunyi 563000Guizhou ProvinceChina Department of Ultrasound Hospital of Traditional Chinese Medicine Affiliated to Southwest Medical UniversityLuzhou 646000Sichuan ProvinceChina

BACKGROUND There are few studies regarding sequential changes in the sagittal alignment of the upper and lower cervical regions of the spine after occipitocervical fusion(OCF).In addition,no comparisons of cervical sagittal alignment(CSA)between patients with craniocervical junction disorders(CJDs)and normal populations have been *** To compare the CSA of patients with CJDs with that of normal controls and investigate the sequential changes in the CSA of the upper and lower cervical spine after *** Eighty-four patients who underwent OCF(OCF group)and 42 asymptomatic volunteers(control group)were *** parameters,including the occipital to C2 angle(O-C2a),occipital and external acoustic meatus to axis angle(O-EAa),C2–7 angle(C2-7a),and pharyngeal inlet angle(PIA),were measured and compared pre-and *** correlations among the parameters were analyzed using Pearson’s correlation *** The O-C2a and PIA of the OCF group were smaller than those of the control group,while their O-EAa and C2-7a values were larger than those of the normal *** were no significant differences in O-C2a,C2-7a,or PIA in the OCF group at baseline,1 mo,or the final follow-up after *** Pearson’s correlation results showed that there were significant correlations between the OC2a and C2Ta,C2-7a,C2-7 sagittal vertical axis(SVA),and PIA at 1 mo after OCF surgery and between O-C2a and O-EAa,C2Ta,C2-7a,C2-7 SVA,and PIA at the final *** Patients with CJDs have a more kyphotic upper CSA and a more lordotic lower CSA than normal *** effectiveness of OCF surgery in restoring CSA may be limited by the realignment of the craniocervical junction being *** reduction in O-C2a after OCF surgery may increase C2-7a and decrease PIA.

关键词： Sagittal alignment occipitocervical fusion Craniocervical disorders Cervical spine Dysphagia

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Comparative the clinical and radiological outcome parameters between occipito-cervical and atlantoaxial fusion in treatment of the unstable Jefferson fracture

Comparative the clinical and radiological outcome parameters...

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2015年浙江省骨科学学术年会

作者： Yong Hu Zhen-shan Yuan Christopher K.Kepler Todd J.Albert Wei-xin Dong Sun xiaoyang Wei-hu Ma Rong-ming Xu Department of Spinal Surgery Ningbo No.6 Hospital Department of Orthopaedic Surgery Thomas Jefferson University & Rothman Institute

Purpose Controversy exists concerning the management of unstable Jefferson fractures,with some surgeons performing external reduction and immobilization of the patient in a Halo vest and others performing surgical reduction and internal *** purpose of this study is to compare the clinical and radiological outcome parameters between posterior atlanto-axial fusion(AAF) and occipito-cervical fusion(OCF) constructs in treatment of the unstable atlas *** In a retrospective evaluation of institutional databases,the authors reviewed medical records and original images obtained in 68 consecutive patients with Unstable Jefferson fracture treated by AAF or OCF between October 2004 and March *** patients were divided into two surgical groups based on radiological findings and were treated with AAF(n=48,F/M:30:18) and OCF(n=20,F/M:13:7) *** blood loss,the time of the operation,the JOA Score,VAS Score,atlas-dens interval(ADI),lateral displacement of the lateral masses(LMD),complications,and the bone fusion rate were *** At the last followed up time,five incomplete paralysis patients(7.4%) showed postoperative improvement by more than 1 grade in their ASIA impairment *** patients with neck pain had relieved *** JOA score of AAF group had improved from 12.5±3.6 preoperatively to 15.7±2.3 postoperatively,the JOA score of OCF group had improved from 11.2±3.3 preoperatively to 14.8±4.2 postoperatively,the VAS score of AAF group had decreased from 4.8 ±1.5 preoperatively to 1.0±0.4 postoperatively,the VAS score of OCF group had decreased from 5.4±2.2 preoperatively to 1.3±0.9 ***,there was no difference in JOA Score and VAS Score between two groups.A statistically significant difference between pre- and post-operation showed the improvement of neurologic *** LMD average distance were 12.5 mm(8.2-16) and 14.6mm(10-19)respectively between AAF group and OCF group before surgery and decreased to

关键词： atlantoaxial fusion occipitocervical fusion Jefferson fractures instrumentation

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