Radiologic criteria to predict injury of the transverse atlantal ligament in unilateral sagittal split fractures of the C1 lateral mass
| Autor: | Kyung-Jin Song, Jong-Beom Park, Dong-Gune Chang, Whoan Jeang Kim, Woo-Kie Min, Heui-Jeon Park, Seung Chan Park |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Lateral mass Observational Study Joint axis 03 medical and health sciences 0302 clinical medicine Clivus medicine Humans 030212 general & internal medicine Cervical Atlas Aged Retrospective Studies unilateral sagittal split fracture medicine.diagnostic_test urogenital system business.industry Magnetic resonance imaging transverse atlantal ligament General Medicine Middle Aged Magnetic Resonance Imaging Sagittal plane Transverse atlantal ligament medicine.anatomical_structure C1 lateral mass 030220 oncology & carcinogenesis Ligaments Articular Spinal Fractures Female business Nuclear medicine radiologic criteria Research Article |
| Zdroj: | Medicine |
| ISSN: | 1536-5964 0025-7974 |
| DOI: | 10.1097/md.0000000000017077 |
| Popis: | Unilateral sagittal split fracture (USSF) of the C1 lateral mass (LM) has been recently recognized as a rare variant of C1 atlas fracture. To date, there has been no study to investigate whether radiologic criteria can be applied to determine the presence or absence of transverse atlantal ligament (TAL) injury in USSF of the C1 LM. Twenty six consecutive cases of USSF of the C1 LM were included in this study. According to Dickman classification, 16 cases were TAL injury, and 10 cases were TAL intact. Radiologic parameters were measured and compared between the 2 groups. Total LM displacement (LMD) of the 2 sides (5.9 ± 2.0 mm vs 1.2 ± 2.0 mm), unilateral LMD of the fracture side (4.3 ± 1.2 mm vs 1.0 ± 1.1 mm), atlanto-dental interval (ADI) (2.0 ± 0.9 mm vs 1.5 ± 0.4 mm), and fracture gap (6.9 ± 2.7 mm vs 2.1 ± 1.1 mm) were statistically higher in the TAL injury group than the TAL intact group. However, basion-dental interval, clivus canal angle, and atlanto-occipital joint axis angle were not different between the 2 groups. Total LMD and unilateral LMD positively correlated with ADI and fracture gap. The incidence of fracture gap larger than 7 mm was statistically higher in the TAL injury group than the TAL intact group (81% vs 30%). In conclusion, total LMD > 5.9 mm or unilateral LMD > 4.3 mm suggests the presence of TAL injury in USSF of the C1 LM. The possibility of diagnostic error for TAL injury can be further reduced in USSF of the C1 LM by considering the fracture gap larger than 7 mm. |
| Databáze: | OpenAIRE |
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