BSD Journal of Spinal Disorders and Techniques Publish Ahead of Print DOI:10.1097/BSD.0000000000000037 Sagittal alignment of spine and spinal cord for upper cervical irreducible atlantoaxial kyphosis in elderly patients Yutaka Sasao M.D., Ph.D.; Atsushi Kojima M.D., Ph.D.; Yoshiaki Torii, M.D.; Shigeta Morioka, M.D.; Atsushi Fujii, M.D.; Moroe Beppu, M.D., Ph.D.; Haruhito Aoki, M.D.
The authors declare no conflict of interest. This manuscript does not contain information about medical device(s)/ or drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Address correspondence and reprint requests to: Yutaka Sasao, M.D., Ph.D., Department of Orthopaedic Surgery, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan E-mail: [email protected] Tel.: +81-44-977-8111 Fax: +81-44-977-9651
Study Design. Retrospective study. Objective. To evaluate clinical and radiographic outcome of posterior decompression and occipito-cervical/thoracic (OCT) fusion in patients with irreducible atlantoaxial kyphosis (IAK). Summary of Background Data. Posterior OCT fusion is an effective surgical procedure for treating IAK in the elderly. However, it is unclear whether correction can be obtained by the strong corrective force provided by implants, even in patients in whom reduction cannot be obtained preoperatively. There are no reports of improvement in patients in whom correction could not be achieved by a rigid system. Methods. Twenty-five patients with IAK with mild vertical subluxation due to rheumatoid arthritis and 3 patients with IAK due to os odontoideum were treated with fossa magnum decompression, C1 laminectomy and OCT fusion. Results. Mean follow-up period was 4.2 years. Pre- and postoperative neurological findings revealed improvement by 1 or more grades in 18 of 28 (64.2%) patients. The parameters of spinal alignment, sagittal spinal cord alignment and basilar invagination were evaluated on radiographs. No significant difference between pre- and postoperative status was seen for the clivo-axial (CA) angle, occipito-upper cervical (O-U) angle, atlantodental interval (ADI) or occipito-cervical (O-C)2 angle, while significant improvement was seen in the cervico-medullary (CM) and dorsal CM (DCM) angles (both P
The authors declare no conflict of interest. This manuscript does not contain information about medical device(s)/ or drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.
Address correspondence and reprint requests to: Yutaka Sasao, M.D., Ph.D., Department of Orthopaedic Surgery, St. Marianna University, School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan E-mail: [email protected] Tel.: +81-44-977-8111 Fax: +81-44-977-9651
Study Design. Retrospective study. Objective. To evaluate clinical and radiographic outcome of posterior decompression and occipito-cervical/thoracic (OCT) fusion in patients with irreducible atlantoaxial kyphosis (IAK). Summary of Background Data. Posterior OCT fusion is an effective surgical procedure for treating IAK in the elderly. However, it is unclear whether correction can be obtained by the strong corrective force provided by implants, even in patients in whom reduction cannot be obtained preoperatively. There are no reports of improvement in patients in whom correction could not be achieved by a rigid system. Methods. Twenty-five patients with IAK with mild vertical subluxation due to rheumatoid arthritis and 3 patients with IAK due to os odontoideum were treated with fossa magnum decompression, C1 laminectomy and OCT fusion. Results. Mean follow-up period was 4.2 years. Pre- and postoperative neurological findings revealed improvement by 1 or more grades in 18 of 28 (64.2%) patients. The parameters of spinal alignment, sagittal spinal cord alignment and basilar invagination were evaluated on radiographs. No significant difference between pre- and postoperative status was seen for the clivo-axial (CA) angle, occipito-upper cervical (O-U) angle, atlantodental interval (ADI) or occipito-cervical (O-C)2 angle, while significant improvement was seen in the cervico-medullary (CM) and dorsal CM (DCM) angles (both P
