Quantitative Correction of Cervical Sagittal Deformity in Atlanto-Axial Dislocation

Spine
Zhenlei LiuZan Chen

Abstract

A mechanism-based reasoning and retrospective cohort study. To establish a quantitative relationship between the change of clivo-axial angle (CXA) and the change of subaxial cervical lordosis (CL) in correction surgery of atlantoaxial dislocation (AAD). The evolving understanding of mechanism has dramatically improved the treatment modality of AAD. Cervical sagittal alignment is another important aspect of the surgery, in addition to reduction of odontoid process. However, a quantitative reference for correction surgery has not been established. Frankfort-axial angle (FXA) was introduced. Based on two assumptions, (1) sagittal alignment of the spine aims at keeping horizontal gaze and (2) deformities at craniovertebral junction make little impact on slope of T1 vertebra, we deduced that the change of CXA equaled change of CL (ΔCXA = -ΔCL). We retrospectively reviewed our case cohort to validate this finding with linear regression analysis. Sixteen cases (eight male and eight female, mean age 40.4±12.5 yr old) were included. Liner fitting equation for ΔFXA and ΔCXA is y=1.005x (coefficient of determination, R=0.966; significance of the estimated coefficients P<0.001, t-statistics) and that for ΔCL and ΔCXA is y=-1.023x (R=0.976,...Continue Reading

References

Jan 1, 1989·Neuroradiology·H SawadaT Koyama
Mar 1, 1994·Surgical Neurology·K TokiyoshiT Kadota
May 6, 2005·Journal of Neurosurgery. Spine·Atul GoelPraveen Sharma
Aug 23, 2011·Journal of Neurosurgery. Spine·Pravin SalunkeNiranjan K Khandelwal
Jul 12, 2014·Journal of Craniovertebral Junction and Spine·Atul Goel
Apr 2, 2015·Neurosurgical Focus·Alejandro J LopezNader S Dahdaleh
Feb 13, 2018·World Neurosurgery·Atul Goel
Jun 12, 2018·Clinical Neurology and Neurosurgery·Pravin SalunkeNarasimhaiah Sunil

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