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ADI, atlantodental interval; ROM, range of motion; CS, cervical spondylosis; OALL, ossification of the anterior longitudinal ligament; BI, basilar impression; AOA, atlanto-occipital assimilation; CYL, Calcification of the yellow ligament; O-C fix, occipitocervical fixation; C1–2 fix, C1–2 fixation; C1 laminec, C1 laminectomy; NA, not available; OPLL, ossification of the posterior longitudinal ligament.
ADI, atlantodental interval; ROM, range of motion; CS, cervical spondylosis; O-C fix, occipito-cervical fixation; C1 laminec, C1 laminectomy; OPLL, ossification of the posterior longitudinal ligament; C1-2 fix, C1-C2 fixation; BI, basilar impression; OALL, ossification of the anterior longitudinal ligament.
Variable | Nonrheumatoid (n = 19) | Rheumatoid (n = 7) | p-value |
---|---|---|---|
Demography | |||
Age (yr) | 73 ± 6 | 68 ± 5 | 0.042* |
Male sex | 10 (53) | 0 (0) | 0.023* |
Cervical lesions | |||
Previous surgery | 5 (26) | 0 (0) | 0.28 |
CS | 13 (68) | 7 (100) | 0.15 |
OALL | 12 (63) | 1 (14) | 0.073 |
OPLL | 3 (16) | 1 (14) | 1.0 |
BI | 3 (16) | 2 (29) | 0.59 |
Radiographical findings | |||
Pseudotumor thickness at diagnosis (mm) | 8.1 (4.2–17.2) | 5.7 (2.7–9.5) | 0.032* |
Atlantodental interval (mm) | 4.8 ± 1.8 | 7.3 ± 2.0 | 0.007* |
AAD | 13 (76) | 7 (100) | 0.28 |
Subaxial ROM (°) | 33.6 ± 20.1 | 40.3 ± 12.2 | 0.42 |
Cyst formation | 4 (21) | 2 (29) | 1.0 |
Calcification | 6 (32) | 3 (43) | 0.66 |
Symptoms | |||
Cervical pain | 9 (47) | 4 (57) | 1.0 |
Preoperative mRS (range) | 3 (1-5) | 2 (1-4) | 0.12 |
Surgical procedures | |||
O-C fixation | 6 (32) | 3 (43) | 0.66 |
C1–2 fixation | 12 (63) | 3 (43) | 0.41 |
C1 laminectomy | 16 (84) | 7 (100) | 0.54 |
Outcomes | |||
Follow-up (mo) | 30 (15–90) | 12 (6–60) | 0.099 |
Pseudotumor thickness at last follow-up (mm) | 4.3 (0.8–9.8) | 3.8 (2.3–7.9) | 0.86 |
Reduction > 50% | 10 (53) | 1 (14) | 0.18 |
Preoperative mRS | 2 (1–4) | 2 (0–3) | 0.36 |
Values are presented as mean±standard deviation, number (%), or median (range).
CS, cervical spondylosis; OALL, ossification of the anterior longitudinal ligament; OPLL, ossification of the posterior longitudinal ligament; BI, basilar impression; ROM, range of motion; mRS, modified Rankin Scale; O-C, occipito-cervical.
Study | No. of cases | Mean age (yr) |
Cervical lesions |
AAI |
Surgical procedures |
Outcomes |
Follow-up (mo) | |||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Previous surgery | Comorbidities | O-C | C1–2 | C1 laminectomy | Tumor resection (approach) | Neurological improvement, n (%) | Radiological improvement, n (%) | |||||
Sze et al. [1], (1986) | 3 | 64 | 1 | CS (2) | 3 | 0 | 0 | 3 | 0 | NA | NA | NA |
Crockard et al. [13], (1991) | 5 | 78 | 1 | CS (5), OPLL (1) | 0 | 0 | 0 | 0 | 4 (transoral) | 2* (100) | NA | NA |
Patel et al. [6], (2002) | 5 | 73 | NA | OALL (5), DISH (5) | NA | 5 | 0 | 1 | 4 (transoral) | 4† (100) | NA | NA |
Suetsuna et al. [16], (2006) | 3 | 72 | NA | NA | 1 | 0 | 0 | 3 (laminoplasty) | 0 | 3 (100) | 3 (100) | 29 |
Yamaguchi et al. [17], (2006) | 3 | 67 | NA | NA | 2 | 3 | 0 | 3 | 0 | 3 (100) | 3 (100) | NA |
Finn et al. [15], (2007) | 18 | NA | NA | NA | 4 | 0 | 18 | 0 | 13 (transoral) | 11 (61) | NA | NA |
Chikuda et al. [4], (2009) | 10 | 71 | NA | CS (7), OALL (6), AOA (1) | 2 | 9 | 0 | 8 | 3 (lateral) | 9 (90) | 8‡ (90) | 30 |
Kakutani et al. [5], (2013) | 7 | 76 | NA | OALL (1), OPLL (2) | 0 | 0 | 0 | 7 | 0 | 7 (100) | 7 (100) | 52 |
Takemoto et al. [20], (2016) | 10 | 76 | NA | CS (5), OPLL (1) | 2 | 0 | 0 | 10 | 0 | 10 (100) | 4 (40) | 29 |
Certo et al. [18], (2019) | 7 | 56 | 2 | CS (7), AOA (3), DISH (2) | 0 | 3 | 4 | 6 | 0 | 6§ (100) | 6§ (100) | 64 |
Naito et al. [14], (2019) | 3 | 75 | NA | NA | 0 | 0 | 0 | 0 | 3 (lateral) | 3 (100) | NA | 21 |
AAI, atlantoaxial instability; AOA, atlanto-occipital assimilation; O-C, occipito-cervical fixation; C1–2, C1–2 fixation; CS, cervical spondylosis; OPLL, ossification of the posterior longitudinal ligament; DISH, diffuse idiopathic skeletal hyperosteosis; NA, not available; OALL, ossification of the anterior longitudinal ligament.