Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression

Li, Dong; Ge, Chao-Yuan; Zhou, Xu; Wang, Dongqi; Sun, Honghui; Hao, Dingjun

doi:10.1155/2020/5395071

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…However, there were three patients whose had further neurological deterioration within 6 months after operation, which is rarely reported in the literature. One possible reason is related to the course of disease, atrophy of the spinal cord, and high T2 signals, which also support our previous findings [25] Preoperative kinematic MRI may provide guidance for these patients in determining whether there is a need to resect the posterior arch of atlas during operation [26]. Based on the above three cases, it is plausible that early intervention should also be performed on atlantoaxial instability patients without neurological dysfunction.…”

Section: Efficacysupporting

confidence: 84%

Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation

Yang

Teng

et al. 2023

J Orthop Surg Res

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Background There are many classification systems for atlantoaxial dislocation (AAD). Among these systems, the definitions of irreducible AAD remain vague, and its treatments are not unified. Objective To explore the surgical strategies and efficacy for the treatment of os odontoideum (OO) with AAD. Methods The clinical data of 56 OO patients with AAD who underwent surgery from January 2017 to June 2021 were retrospectively analyzed. AAD was classified into four types, Type I and type II were treated with posterior fixation and fusion. Type III received posterior fixation and fusion after irreducible dislocations were converted to reducible dislocations by translateral mass release or transoral release. Type IV required transoral release for conversion into reducible dislocations before posterior fixation and fusion. The operation time, blood loss, and complications were recorded. The preoperative and postoperative neurological function changes were assessed using the Japanese Orthopedic Association (JOA) score. Postoperative fusion status was assessed by X-ray. Results There were 40 cases of type I-II, 14 cases of type III, and two cases of type IV AAD. The operation times of single posterior fixation and fusion, combined translateral mass release and combined transoral release were 130.52 ± 37.12 min, 151.11 ± 16.91 min and 188.57 ± 44.13 min, the blood loss were 162.63 ± 58.27 mL, 235.56 ± 59.94 mL, 414.29 ± 33.91 mL, respectively. One patient with type III died, one with type III underwent revision surgery due to infection, and three patients with type I had further neurological deterioration after operation. fifty-five patients were followed up for 12–24 months. The follow-up results showed that enough decompression was achieved and that fixation and fusion were effective. The JOA score increased from 9.58 ± 1.84 points preoperative to 13.09 ± 2.68 points at 3 months after operation, 14.07 ± 2.83 points at 6 months and 14.25 ± 2.34 at 12 months after operation, all significant differences compared with preoperative results (P < 0.05). Conclusion OO patients with irreducible AAD can be treated by translateral mass release or transoral release combined with posterior fixation and fusion, while some of those with bony fusion can be treated by transoral release combined with posterior fixation and fusion.

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Section: Efficacysupporting

confidence: 84%

Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation

Yang

Teng

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…However, all three patients had further neurological deterioration within 6 months after operation, which is rarely reported in the literature. One possible reason is related to the course of disease, atrophy of the spinal cord, and high T2 signals, which also support our previous ndings [22] Preoperative kinematic MRI may provide guidance for these patients in determining whether there is a need to resect the posterior arch of atlas during operation [23]. Based on the above three cases, it is plausible that early intervention should also be performed on atlantoaxial instability patients without neurological dysfunction.…”

Section: E Cacysupporting

confidence: 80%

Analysis of Surgical Strategies and Efficacy in the Treatment of Os Odontoideum with Atlantoaxial Dislocation

Yang

Teng

et al. 2022

Preprint

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Background: There are many classification systems for atlantoaxial dislocation (AAD). Among these systems, the definitions of irreducible AAD remain vague, and its treatments are not unified. Objective: To explore the surgical strategies and their efficacy for the treatment of os odontoideum (OO) with AAD. Methods: The clinical data of 56 OO patients with AAD who underwent surgery from January 2017 to June 2021 were retrospectively analyzed. AAD was classified into four types, Type I and type II were treated with posterior fixation and fusion. Type III received posterior fixation and fusion after irreducible dislocations were converted to reducible dislocations by trans lateral mass release or transoral release. Type IV required transoral release for conversion into reducible dislocations before posterior fixation and fusion. The operation time, intraoperative blood loss, and perioperative complications were recorded. The preoperative and postoperative neurological function changes were assessed using the Japanese Orthopedic Association (JOA) score. Postoperative fusion status was assessed by X-ray or CT scan. Results: There were 40 cases (71%) of type I-II, 14 cases (25%) of type III, and two cases (4%) of type IV AAD. The operation time was 137.5±42.04 min, and the blood loss was 202.85±171.21 mL. One patient with type III died, one with type III underwent revision surgery due to infection, and three patients with type I had further neurological deterioration after operation. Except for the patients who died, all patients were followed up for 12-24 months. The follow-up results showed that sufficient decompression was achieved and that the fixation and fusion were effective. The JOA score increased from 9.58±1.84 points before operation to 13.09±2.68 points at 3 months after operation,14.07±2.83 points at 6 months and 14.25±2.34 at 12 months after operation, all significant differences comparison with preoperative results (P<0.05). Conclusion: OO patients with irreducible AAD can be treated by trans lateral mass release or transoral release combined with posterior fixation and fusion, while some of those with bony fusion can be treated by transoral release combined with posterior fixation and fusion.

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EEG spectral and microstate analysis originating residual inhibition of tinnitus induced by tailor-made notched music training

Zhu,

Gong

2023

Front. Neurosci.

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Tailor-made notched music training (TMNMT) is a promising therapy for tinnitus. Residual inhibition (RI) is one of the few interventions that can temporarily inhibit tinnitus, which is a useful technique that can be applied to tinnitus research and explore tinnitus mechanisms. In this study, RI effect of TMNMT in tinnitus was investigated mainly using behavioral tests, EEG spectral and microstate analysis. To our knowledge, this study is the first to investigate RI effect of TMNMT. A total of 44 participants with tinnitus were divided into TMNMT group (22 participants; ECnm, NMnm, RInm represent that EEG recordings with eyes closed stimuli-pre, stimuli-ing, stimuli-post by TMNMT music, respectively) and Placebo control group (22 participants; ECpb, PBpb, RIpb represent that EEG recordings with eyes closed stimuli-pre, stimuli-ing, stimuli-post by Placebo music, respectively) in a single-blind manner. Behavioral tests, EEG spectral analysis (covering delta, theta, alpha, beta, gamma frequency bands) and microstate analysis (involving four microstate classes, A to D) were employed to evaluate RI effect of TMNMT. The results of the study showed that TMNMT had a stronger inhibition ability and longer inhibition time according to the behavioral tests compared to Placebo. Spectral analysis showed that RI effect of TMNMT increased significantly the power spectral density (PSD) of delta, theta bands and decreased significantly the PSD of alpha2 band, and microstate analysis showed that RI effect of TMNMT had shorter duration (microstate B, microstate C), higher Occurrence (microstate A, microstate C, microstate D), Coverage (microstate A) and transition probabilities (microstate A to microstate B, microstate A to microstate D and microstate D to microstate A). Meanwhile, RI effect of Placebo decreased significantly the PSD of alpha2 band, and microstate analysis showed that RI effect of Placebo had shorter duration (microstate C, microstate D), higher occurrence (microstate B, microstate C), lower coverage (microstate C, microstate D), higher transition probabilities (microstate A to microstate B, microstate B to microstate A). It was also found that the intensity of tinnitus symptoms was significant positively correlated with the duration of microstate B in five subgroups (ECnm, NMnm, RInm, ECpb, PBpb). Our study provided valuable experimental evidence and practical applications for the effectiveness of TMNMT as a novel music therapy for tinnitus. The observed stronger residual inhibition (RI) ability of TMNMT supported its potential applications in tinnitus treatment. Furthermore, the temporal dynamics of EEG microstates serve as novel functional and trait markers of synchronous brain activity that contribute to a deep understanding of the neural mechanism underlying TMNMT treatment for tinnitus.

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Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression

Cited by 3 publications

References 15 publications

Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation

Analysis of surgical strategies and efficacy in the treatment of Os odontoideum with atlantoaxial dislocation

Analysis of Surgical Strategies and Efficacy in the Treatment of Os Odontoideum with Atlantoaxial Dislocation

EEG spectral and microstate analysis originating residual inhibition of tinnitus induced by tailor-made notched music training

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