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Prevalence of Degenerative Changes of the Atlanto-Axial Joints.
MedLine Citation:
PMID:  25277533     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND CONTEXT: Degeneration of the atlanto-dens and atlanto-axial joints is associated with cervical spine pain and may also be associated with an increased risk of dens fracture. However, there is paucity of literature describing the prevalence of specific degenerative changes in the atlanto-dens and atlanto-axial facet joints.
PURPOSE: To document age-related degenerative changes of the cervical spine in a large cohort of patients Study Design/Setting: This is a retrospective cohort study.
PATIENT SAMPLE: Adult trauma patients admitted to our level 1 trauma center.
OUTCOME MEASURES: Osteoarthritis of the atlanto-dens and atlanto-axial facet joints of the cervical spine as well as the presence of intraosseous cyst and calcific synovitis, as determined by CT scans.
METHODS: We conducted a retrospective study of 1,543 adult trauma patients who received a cervical spine computed tomography scan. The anterior atlanto-dens joint interval was measured. The presence or absence of intraosseous cysts and calcific synovitis was recorded. Degeneration of the atlanto-dens and atlanto-axial facet joints at age intervals was quantified.
RESULTS: The atlanto-dens interval narrowed linearly with age (R(2) = 0.992; p<0.001). The prevalence of intraosseous cysts increased exponentially with age from 4.2% to 37.4%, and calcific synovitis increased from 0% to 11.1%. Intraosseous cyst formation generally began in the 2nd to 3rd decade of life and synovitis in the 5th and 6th decade of life. Facet joints also demonstrated age related changes; however, the rate of degenerative changes was lower than in the atlanto-dens joint.
CONCLUSIONS: To our knowledge, this is the first study that documents specific changes of both atlanto-dens and atlanto-axial facet joints as a function of age in a large cohort of 1,543 patients. These changes increased exponentially with age, and may contribute to pain and limitation in motion. In light of our findings and recent studies demonstrating the association between degeneration and dens fracture in elderly, cervical spine radiographs of elderly patients should be carefully assessed for these changes.
Authors:
Marcel Betsch; Sabina R Blizzard; Matthew Shinseki; Jung Yoo
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-9-29
Journal Detail:
Title:  The spine journal : official journal of the North American Spine Society     Volume:  -     ISSN:  1878-1632     ISO Abbreviation:  Spine J     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-10-3     Completed Date:  -     Revised Date:  2014-10-4    
Medline Journal Info:
Nlm Unique ID:  101130732     Medline TA:  Spine J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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