Anatomical analysis of the occipital bone in patients with basilar invagination: a computed tomography-based study

Ji, Wei; Shen, Lin; Bao, Minggui; Zou, Xiaobao; Ge, Shen; Ma, Xiangyang; Chen, Jianting; Yang, Jincheng

doi:10.1016/j.spinee.2020.01.005

Cited by 8 publications

(9 citation statements)

References 27 publications

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“…Craniocervical junction disorders often require reconstruction of stability through strong internal xation. At present, screw-rod xation is most commonly used in posterior atlantoaxial xation [9,10], and plate-screw-rod xation in posterior occipitocervical xation [11,12].…”

Section: Discussionmentioning

confidence: 99%

The Application of A Crossed Rod Configuration in Posterior Occipitocervical and Atlantoaxial Fixation: A Retrospective Study of 21 Cases

Zou

Feng

Ouyang

et al. 2022

Preprint

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Background. The crossed rod configuration is a novel connection type for posterior occipitocervical and atlantoaxial fixation, which has been reported to have better biomechanical stability than existing configurations. However, the clinical application of this technique has yet to be studied. Objective. To evaluate the clinical outcome of the crossed rod configuration applied in posterior occipitocervical and atlantoaxial fixation. Methods. From January 2011 to December 2014, 21 patients with craniocervical junction disorders were treated surgically, and stability was reconstructed by posterior occipitocervical or atlantoaxial fixation with a crossed rod configuration. The patients’ clinical data were retrospectively analyzed. Internal fixation, neurological status, clinical symptoms, bone fusion, and complications were evaluated. Results. All surgeries were successful with no neurovascular injury in any of the patients. Clinical symptoms were relieved in all 21 patients (100%). Satisfactory internal fixation was found on postoperative images. Japanese Orthopaedic Association scores and occipitocervical visual analog scale ratings were significantly improved after operation (P < 0.05). The average follow-up duration was 22.7 ± 7.5 months (range 12–36 months). All patients achieved bone fusion without complications during the follow-up. Conclusions. The application of a crossed rod configuration in posterior occipitocervical and atlantoaxial fixation provides reliable stabilization and may be a viable alternative to current configuration methods for clinical use.

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Section: Discussionmentioning

confidence: 99%

The Application of A Crossed Rod Configuration in Posterior Occipitocervical and Atlantoaxial Fixation: A Retrospective Study of 21 Cases

Zou

Feng

Ouyang

et al. 2022

Preprint

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“…In our previous research, the characteristics of the cranial-cervical spinal canal 16 , the thickness of the occipital bone 17 , and the anatomic feature of clivus with atlas assimilation 32 were investigated in patients with congenital malformation in CVJ region. The present study described the cervical curvature and the ROMs of relative parameters in BI patients, supplementing the lack of the morphological feature of cervical alignment in this population.…”

Section: Clinical Relevance Of Cervical Alignmentmentioning

confidence: 99%

“…We further investigated the morphology of cranial-cervical spinal canal in BI patients, finding that the BI patients presented a shorter anteroposterior diameter, but a wider transversal diameter at the upper cranial-cervical spinal canal 16 . In addition, our previous research revealed that the BI patients had a thinner occipital bone than control group, which might increase the risk of screw penetration in surgical fixation 17 .…”

Section: Introductionmentioning

confidence: 96%

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study

Lin

Bao

Shen

et al. 2022

Orthopaedic Surgery

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Objective: To investigate the cervical alignment and the relative range of motion (ROM) in patients with basilar invagination (BI).Methods: A total of 40 BI cases (38.1 years old AE 17.9 years old, 19 male and 21 female) and 80 asymptomatic individuals (33.8 years old AE 10.8 years old, 40 male and 40 female) were included. The Skull-C 2 /Skull-BV, Skull-C 7 , C 2 -C 7 /BV-C 7 wall angles, C 0 -C 2 /C 0 -BV, C 0 -C 7 , C 1 -C 7 , and C 2 -C 7 /BV-C 7 angles were measured in dynamic X-ray images (including neutral, extension, and flexion positions). Correlation between the upper and lower cervical curvatures were analyzed. The total, extension, and flexion ROMs of these angles were calculated, respectively. Results:The BI patients had a smaller C 0 -C 2 /C 0 -BV angle (18.2 AE 16.4 vs 30.9 AE 9.3 ), but larger C 2 -C 7 /BV-C 7 (32.2 AE 16.1 vs 19.4 AE 10.6 ) and C 2 -C 7 /BV-C 7 wall angles (37.8 AE 17.2 vs 23.6 AE 10.2 ) than the control group in neutral position. The upper and lower curvatures correlated negatively in neutral (r = À0.371), extension (r = À0.429), and flexion (r = À0.648) positions among BI patients, as well as in extension position (r = À0.317) among control group. The BI patients presented smaller total ROMs in Skull-C 2 /Skull-BV (12.3 AE 16.6 vs 19.7 AE 10.9 ), C 0 -C 2 /C 0 -BV (8.1 AE 11.1 vs 17.6 AE 10.5 ), and C 0 -C 7 angles (57.8 AE 14.2 vs 78.3 AE 17.9 ), but a larger total ROM in C 2 -C 7 /BV-C 7 wall angle (52.8 AE 13.9 vs 27.0 AE 16.1 ) than the control group. The BI patients also presented smaller extension ROMs in Skull-C 2 /Skull-BV (6.9 AE 9.4 vs 12.5 AE 9.3 ), Skull-C 7 (24.5 AE 10.9 vs 30.7 AE 12.5 ), and C 0 -C 2 /C 0 -BV angles (4.4 AE 7.8 vs 9.9 AE 8.6 ) than the control group. Moreover, the BI patients showed smaller absolute values of flexion ROMs in Skull-C 2 /Skull-BV (À5.2 AE 9.4 vs À7.3 AE 8.0 ), C 0 -C 2 /C 0 -BV (À3.2 AE 8.8 vs À7.7 AE 8.7 ), and C 0 -C 7 angles (À33.2 AE 13.0 vs À52.8 AE 19.2 ), but a larger absolute value of flexion ROM in C 2 -C 7 /BV-C 7 wall angle (À33.9 AE 14.8 vs À8.2 AE 15.1 ). Conclusion:The cervical spine was stiffer in BI patients than the asymptomatic individuals, especially in the upper cervical curvature. The negative correlation between upper and lower cervical curvatures was more obvious in BI patients.

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“…The dimensions and angulations of all subaxial (C3-C7) vertebrae were measured using RadiAnt DICOM Viewer software (version 5.5.1, Medixant, Poland). The following parameters (Figure 1) were evaluated in the axial section: (1) the pedicle width (PW) was defined as the narrowest portion of pedicle; (2) the pedicle length (PL) was measured between the entry point in the lateral cortex and the end point in the anterior cortex of vertebra body; (3) the pedicle angle (PA) was defined as the angle between the axis of pedicle and a line passing through the spinous process and vertebra body, which divided the vertebrae into two hemi-vertebrae; (4) the maximum laminar length (LL) was defined as the length from the junction of laminar and spinous process to the lateral cortex of lateral mass, and the minimum laminar length (LLn) was measured from the junction of the lamina and spinous process to the junction of the laminar and lateral mass; (5) the laminar width (LW) was defined as the shortest distance portion of the laminar; (6) the laminar angle (LA) was measured as the angle from the axis of lamina to a line passing through the spinous process and vertebra body; (7) the length of lateral mass (LML) was measured from the point of transition from the laminar to the mass to the opposite cortex; (8) the width of lateral mass (LMW) was measured at its widest point. The height of the subaxial cervical pedicle and laminar (PH and LH) was measured in the sagittal plane (Figure 2A, B).…”

Section: Radiological Measurementsmentioning

confidence: 99%

“…Patients often present with atlas hypoplasia, occipital condyle hypoplasia, atlantooccipital assimilation, and atlantal lateral mass dysplasia. [3][4][5][6][7] These factors stress the association of BI and osseous anomalies of the craniovertebral junction (CVJ). Researchers have previously investigated the characteristics of CVJ in BI patients.…”

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confidence: 99%

Morphological Evaluation of the Subaxial Cervical Spine in Patients with Basilar Invagination

Shen

Bao

Wang

et al. 2021

Spine

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Study Design. Retrospective study. Objective. To evaluate the morphologic features of the subaixal cervical spine in patients with basilar invagination (BI) and provide information for the accurate screw placement in this region. Summary of Background Data. BI is a congenital anomaly, comprising a wide range of abnormal structures. The screw fixation can be required in situation that BI is combined with subaxial cervical spine pathologies. However, there are no literatures specifically addressed the subaxial cervical morphology of BI. Method. A total of 42 BI patients were included in this retrospective study. Forty-two patients without head or cervical disease were matched for sexes and ages. Information on radiographic features of the subaxial cervical spine was collected and compared systematically. Results. There were no differences in the age and sex between the BI and control group. The BI group manifested a wider pedicle and laminar than the control group at all cervical levels, except for the pedicle of C6 and C7, and the laminar of C3 and C6. In addition, the BI group had a wider lateral mass from C3 to C5 than the control group. There were no differences in most measurements of the length of pedicle, laminar, and lateral mass. Conclusion. BI patients have a wider pedicle and laminar than the general population in the subaxial cervical spine, but the same size in length of pedicle, laminar, and lateral mass.

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Anatomical analysis of the occipital bone in patients with basilar invagination: a computed tomography-based study

Cited by 8 publications

References 27 publications

The Application of A Crossed Rod Configuration in Posterior Occipitocervical and Atlantoaxial Fixation: A Retrospective Study of 21 Cases

The Application of A Crossed Rod Configuration in Posterior Occipitocervical and Atlantoaxial Fixation: A Retrospective Study of 21 Cases

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study

Morphological Evaluation of the Subaxial Cervical Spine in Patients with Basilar Invagination

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