Atlanto-axial rotary instability (Fielding type 1): characteristic clinical and radiological findings, and treatment outcomes following alignment, fusion, and stabilization
| Autor: | Kelly Tuchman, Malini Narayanan, Fraser C. Henderson, Peter C. Rowe, Robert Rosenbaum, Clair Francomano, Myles Koby |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Joint Instability Male medicine.medical_specialty Lightheadedness Adolescent Atlanto-axial Bone Screws Joint Dislocations Rotary subluxation Syncope 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine Vertigo Dynamic imaging medicine Humans C1-C2 fusion Retrospective Studies Subluxation Neck pain biology business.industry Alar ligament General Medicine Middle Aged biology.organism_classification medicine.disease Surgery medicine.anatomical_structure Spinal Fusion Treatment Outcome Atlanto-Axial Joint Joint pain Rheumatoid arthritis Original Article Female Neurology (clinical) Headaches medicine.symptom business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Neurosurgical Review |
| ISSN: | 1437-2320 0344-5607 |
| Popis: | Atlanto-axial instability (AAI) is common in the connective tissue disorders, such as rheumatoid arthritis, and increasingly recognized in the heritable disorders of Stickler, Loeys-Dietz, Marfan, Morquio, and Ehlers-Danlos (EDS) syndromes, where it typically presents as a rotary subluxation due to incompetence of the alar ligament. This retrospective, IRB-approved study examines 20 subjects with Fielding type 1 rotary subluxation, characterized by anterior subluxation of the facet on one side, with anormal atlanto-dental interval. Subjects diagnosed with a heritable connective tissue disorder, and AAI had failed non-operative treatment and presented with severe headache, neck pain, and characteristic neurological findings. Subjects underwent a modified Goel-Harms posterior C1-C2 screw fixation and fusion without complication. At 15 months, two subjects underwent reoperation following a fall (one) and occipito-atlantal instability (one). Patients reported improvement in the frequency or severity of neck pain (P P = 0.001), headaches, pre-syncope, and lightheadedness (allP P = 0.01), and syncope, nausea, joint pain, and exercise tolerance (allP |
| Databáze: | OpenAIRE |
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