Retrospective review of 22 surgically treated adults with congenital anomalies of the upper cervical spine: a clinical and radiological review

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
Haku IizukaKenji Takagishi

Abstract

The purpose of this study was to clarify the characteristics of adult cases with instability due to upper cervical spine anomalies who needed fusion surgery regarding the clinical and radiological findings. Twenty-two consecutive patients with instability due to upper cervical spine anomaly in adult cases were reviewed. The congenital anomalies included idiopathic atlanto-axial subluxation in nine cases, os odontoideum in seven cases, occipitalization of the atlas in four cases, atlanto-occipital subluxation in one case and AAS with another anomaly in one case. We evaluated the severity of neurological symptoms before surgery and at the last follow-up. We also observed MR images before and 1 year after surgery. Before surgery, the 22 patients included seven Ranawat Grade I cases, ten Ranawat Grade II cases, and five Ranawat Grade IIIa cases. Regarding the neurological status after surgery, those included eighteen Ranawat Grade I cases, three Ranawat Grade II cases, and one Ranawat Grade IIIa case. Preoperative T2-weighted MR images demonstrated intramedullary high signal intensity (IHSI) in 12 cases. IHSI group did not include significantly more Ranawat Grade IIIa cases compared to the remaining 10 cases. In postoperative MR im...Continue Reading

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