The characteristics of cervical sagittal alignment at different C0-C2 correcting angles in fusion treatment of atlantoaxial dislocations.

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The characteristics of cervical sagittal alignment at different C0-C2 correcting angles in fusion treatment of atlantoaxial dislocations.

World Neurosurg. 2018 Dec 21;:

Authors: Xiuru Z, Kun G, Huiqi X, Yanzheng G

Abstract
PURPOSE: To explore the appropriate range of C0-C2 correction angles by analyzing cervical sagittal alignment parameters and evaluating clinical outcomes.
METHODS: The pre-operative and postoperative radiographs, visual analogue scale (VAS), Japanese Orthopedic Association (JOA) score, and neck disability index (NDI) of 65 AAD patients were retrospectively collected. The C0-C2 angle, C2-C7 angle, and cervical sagittal vertical axis (cSVA) were measured from the radiographs, and an assessment of cervical disc degenerative disease (cDDD) was made. According to the 2-year postoperative C0-C2 angles, all patients were categorized into a ˂10° subgroup, 10°-20° subgroup and ˃20° subgroups.
RESULTS: The postoperative C2-C7 angles and cSVA of the 10-20° subgroup were significantly different from those of the ˂10° subgroup. The JOA of the 10-20° subgroup was significantly different from those of the ˂10° and ˃20° subgroups. All patients (26/26) in the 10-20° subgroup exhibited a cSVA 0-40 mm, 25% of patients (6/24) in the ˃20° subgroup exhibited a cSVA ˃40 mm, and 40% of patients (6/15) in the ˂10° subgroup showed a cSVA ˂0 mm. The postoperative incidence of cDDD did not increase in the 10-20° subgroup.
CONCLUSION: AAD patients with different C0-C2 postoperative angles had different cervical sagittal alignments and clinical outcomes. In our study, the patients within the C0-C2 10-20° subgroup exhibited superior clinical outcomes and cervical sagittal alignment.

PMID: 30583133 [PubMed - as supplied by publisher]

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