التفاصيل البيبلوغرافية
| العنوان: |
Unilateral C1 Lateral Mass and C2 Pedicle Screw Fixation for Atlantoaxial Instability in Rheumatoid Arthritis Patients : Comparison with the Bilateral Method. |
| المؤلفون: |
Seung-Chull Paik, Hyoung-Joon Chun, Koang Hum Bak, Jeil Ryu, Kyu-Sun Choi |
| المصدر: |
Journal of Korean Neurosurgical Society; Jun2015, Vol. 57 Issue 6, p460-464, 5p |
| مصطلحات موضوعية: |
VERTEBRAL artery, COMPUTED tomography, RHEUMATOID arthritis, INFLAMMATION, PUBLIC health |
| مستخلص: |
Objective : Bilateral C1 lateral mass and C2 pedicle screw fixation (C1LM-C2P) is an ideal technique for correcting atlantoaxial instability (AAI). However, the inevitable situation of vertebral artery injury or unfavorable bone structure may necessitate the use of unilateral C1LM-C2P. This study compares the fusion rates of the C1 lateral mass and C2 pedicle screw in the unilateral and bilateral methods. Methods : Over five years, C1LM-C2P was performed in 25 patients with AAI in our institute. Preoperative studies including cervical X-ray, three-dimensional computed tomography (CT), CT angiogram, and magnetic resonance imaging were performed. To evaluate bony fusion, measurements of the atlanto-dental interval (ADI) and CT scans were performed in the preoperative period, immediate postoperative period, and postoperatively at 1, 3, 6, and 12 months. Results : Unilateral C1LM-C2P was performed in 11 patients (44%). The need to perform unilateral C1LM-C2P was due to anomalous course of the vertebral artery in eight patients (73%) and severe degenerative arthritis in three patients (27%). The mean ADI in the bilateral group was 2.09 mm in the immediate postoperative period and 1.75 mm in 12-months postoperatively. The mean ADI in the unilateral group was 1.82 mm in the immediate postoperative period and 1.91 mm in 12-months postoperatively. Comparison of ADI measurements showed no significant differences in either group (p=0.893), and the fusion rate was 100% in both groups. Conclusion : Although bilateral C1LM-C2P is effective for AAI from a biomechanical perspective, unilateral screw fixation is a useful alternative in patients with anatomical variations. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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