| Risk factors for development of subaxial subluxations following atlantoaxial arthrodesis for atlantoaxial subluxations in rheumatoid arthritis. | |
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MedLine Citation:
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PMID: 20072093 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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STUDY DESIGN: Retrospective radiographic/imaging study. OBJECTIVE: To evaluate preoperative and sequential postoperative radiographs following C1-C2 arthrodesis for atlantoaxial subluxation in patients with rheumatoid arthritis (RA) to determine risk factors for the development of subaxial subluxations (SAS). SUMMARY OF BACKGROUND DATA: The development of SAS has often been observed after C1-C2 arthrodesis. However, there have been no previous reports on the correlation between radiographic parameters and the incidence of postoperative SAS. METHODS: The study group comprised of 58 patients with RA who underwent C1-C2 arthrodesis due to atlantoaxial subluxation. There were 5 men and 53 women with a mean age of 55.8 years. The mean follow-up period was 137 months. Nineteen patients with a postoperative SAS after C1-C2 arthrodesis were classified as the SAS+ group. Other 39 patients without a postoperative SAS were included in the SAS- group. Clinical outcomes and plain radiographs were reviewed retrospectively and compared between the 2 groups. RESULTS: The difference between pre- and postoperative atlantoaxial (AA) angles in the SAS+ group was significantly greater than those in the SAS- group (P = 0.039). The C2-C7 angles changed significantly between pre- and postoperative periods in the SAS+ group (P = 0.039), but not in the SAS- group (P = 0.897). It was suggested that a large AA angle and a small C2-C7 angle observed at the early postoperative period were the risk factors for the development of SAS. We also demonstrated that a high incidence of the C3-C4 SAS resulted from excessive bone fusion at the C2-C3. CONCLUSION: Excessive correction of AA angle is likely to cause loss of cervical lordosis, resulting in the development of postoperative SAS. In addition, extensive bony union at C2-C3 following C1-C2 arthrodesis frequently leads to the development of extensive SAS at the C3-C4. |
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Authors:
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Ken Ishii; Morio Matsumoto; Yuichiro Takahashi; Eijiro Okada; Kota Watanabe; Takashi Tsuji; Hironari Takaishi; Masaya Nakamura; Yoshiaki Toyama; Kazuhiro Chiba |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 1551-5 Citation Subset: IM |
Affiliation:
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Department of Orthopaedic Surgery, School of Medicine, Keio University, Shinjuku, Tokyo, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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