| Three-dimensional morphology and kinematics of the craniovertebral junction in rheumatoid arthritis. | |
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MedLine Citation:
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PMID: 20736886 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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STUDY DESIGN: A case-series study. OBJECTIVES: To measure the 3-dimensional (3D) morphology and kinematics of the craniovertebral junction (CVJ) using a 3D computed tomography (CT) model; to reveal abnormal patterns and the relationships between pathology and kinematics. SUMMARY OF BACKGROUND DATA: Evaluations using radiography, 2-dimensional (2D) CT and magnetic resonance imaging have limitations because of the complex 3D structure of the CVJ. METHODS: Twenty-four rheumatoid arthritis patients (21 females, 3 males) with cervical involvement underwent CT scanning of the cervical spine from the basilar process of the occipital bone to the first thoracic vertebra in neutral and flexed positions. The 3D morphology of the occipital condyle, atlas, and axis were classified based on the type of deformity observed. Periodontoid lesions (continuous bony lesions between the atlas and the odontoid process) were also noted. The 3D kinematics in the atlanto-occipital and atlantoaxial joints were evaluated using the volume merge method. RESULTS: Deformities in the atlanto-occipital joints appeared more frequently than those in the atlantoaxial joints. The most common instability pattern was flexural rotation during flexion at the CVJ. The direction of translational motions during flexion was posterior in the atlanto-occipital joint and anterior and caudal in the atlantoaxial joint. CONCLUSION: The results suggest that bilateral occipital condyle deformation, unilateral and bilateral mass collapse, and periodontoid lesions may affect flexion/extension rotational instability in the atlantoaxial joint. In addition, unilateral occipital condyle deformation and atlantoaxial joint stability may affect sagittal translational instability to the posterior side in the atlanto-occipital joint. The noninvasive 3D CT imaging technique employed here would be useful for predicting the prognosis of patients with rheumatoid deformities at the CVJ. |
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Authors:
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Ryota Takatori; Daisaku Tokunaga; Hitoshi Hase; Yasuo Mikami; Takumi Ikeda; Tomohisa Harada; Kan Imai; Hirotoshi Ito; Tsunehiko Nishimura; Howard S An; Nozomu Inoue; Toshikazu Kubo |
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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 Nov |
Date Detail:
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Created Date: 2010-10-26 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: E1278-84 Citation Subset: IM |
Affiliation:
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Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan. r-taka@koto.kpu-m.ac.jp |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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