Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression

Autor: Liang Dong, Chaoyuan Ge, Honghui Sun, Dingjun Hao, Zhengwei Xu, Dongqi Wang
Rok vydání: 2020
Předmět:
Adult
Male
musculoskeletal diseases
medicine.medical_specialty
Article Subject
Decompression
medicine.medical_treatment
Joint Dislocations
General Biochemistry
Genetics and Molecular Biology
03 medical and health sciences
0302 clinical medicine
Spinal cord compression
medicine
Humans
Postoperative Period
Spinal Cord Injuries
Reduction (orthopedic surgery)
Aged
Retrospective Studies
030222 orthopedics
General Immunology and Microbiology
medicine.diagnostic_test
business.industry
X-Rays
Laminectomy
Magnetic resonance imaging
General Medicine
Middle Aged
Decompression
Surgical
Spinal cord
medicine.disease
Magnetic Resonance Imaging
Biomechanical Phenomena
Treatment Outcome
medicine.anatomical_structure
Atlanto-Axial Joint
Spinal Cord
Spinal decompression
Dynamic contrast-enhanced MRI
Medicine
Female
Radiology
Tomography
X-Ray Computed
business
Spinal Cord Compression
030217 neurology & neurosurgery
Research Article
Zdroj: BioMed Research International, Vol 2020 (2020)
BioMed Research International
ISSN: 2314-6141
2314-6133
DOI: 10.1155/2020/5395071
Popis: Background. Many doctors ignored the possibility that there is still a spinal cord compression (SCC) need for decompression after atlantoaxial reduction. Reduction can be achieved on kinematic magnetic resonance imaging (MRI); thus, we want to analyze the role of kinematic MRI in reducible atlantoaxial dislocation and make a preoperative decision whether to perform decompression. Methods. 36 patients with atlantoaxial reduction on preoperative kinematic MRI in extension postures were enrolled retrospectively. Grouping was based on the condition of SCC after atlantoaxial reduction preoperatively. Group A: patients with SCC after atlantoaxial reduction on dynamic cervical MRI were treated with C1 laminectomy for decompression and atlantoaxial fixation. Group B: patients with no significant SCC, according to dynamic MRI, underwent only atlantoaxial fixation. Clinical outcomes were evaluated using JOA score for spinal cord function. Radiological outcomes were assessed by measuring spinal cord diameter on MRI. Results. The mean follow-up time was 17.1 months. Postoperative JOA score and percentage of SCC in both groups were significantly better than its preoperative score. There were no significant statistical differences in the JOA score at 12 months after surgery and the JOA improvement rate between two groups. All patients in the two groups had a lower percentage of SCC on preoperative extension MRI, compared with neutral MRI. No significant statistical differences in the spinal decompression improvement rate were observed between the two groups. Conclusions. Decompression should be performed in patients who still have significant SCC on preoperative kinematic MRI. Kinematic MRI could be used to assess SCC and decide whether to perform decompression preoperatively.
Databáze: OpenAIRE
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