Pathomechanism of Atlantoaxial Rotatory Fixation in Children

Kawabe, Naomi; Hirotani, Hayato; Tanaka, Osamu

doi:10.1097/01241398-198909010-00012

Cited by 87 publications

(39 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although Kawabe et al (1989) investigated the atlantoaxial joints of six infant cadavers (age from 0-2 years) and Yu et al (1987) reported that synovial folds were found in a 10-year-old child's cervical spine, no one has done systemic research on synovial folds in child cervical spines, especially in children whose age range from 2 to 11 years, who are more likely to suffer from AARD. The data of synovial folds of cervical spines of the stage were supplemented in this study.…”

Section: Discussionmentioning

confidence: 97%

“…E-mail: tangxueyang100@263.net nificances of the synovial folds is still unclear, especially in the occipito-atlanto-axial joints. Although Kawabe et al (1989) and Mercer and Bogduk (1993) have suggested that the synovial folds in the atlantoaxial joints may play a role in the pathology of some disorders of the neck, such as atlantoaxial rotatory deformity (AARD), the data showing that children were more likely to suffer from the AARD is not to be found in the literature. We have reviewed the literature regarding the synovial folds in this region.…”

Section: Introductionmentioning

confidence: 85%

“…On the other hand, under some conditions, the synovial folds may be a pathogenic factor. A few authors have studied synovial folds in the cervical spinal joints (Yu et al, 1987;Kawabe et al, 1989;Chang et al, 1992;Lang, 1993;Mercer and Bogduk, 1993;Schonstrom et al, 1993;Inami et al, 2000Inami et al, , 2001. However, the morphology, distribution, and clinical sig-*Correspondence to: Li-Jun Liu and Xue-Yang Tang, Department of Pediatric Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China 610041.…”

Section: Introductionmentioning

confidence: 96%

See 2 more Smart Citations

Anatomic study of the synovial folds of the occipito‐atlanto‐axial joints

Tang¹,

Liu²,

Yang³

et al. 2006

Clinical Anatomy

View full text Add to dashboard Cite

This study was performed to observe and measure synovial folds of the occipito-atlanto-axial joints and to explore their clinical significance. Two hundred ninety eight occipito-atlanto-axial joints from 30 embalmed cadavers of children and 20 of adults were dissected to find the incidence, quantity, distribution, forms, dimension, and histology of synovial folds. Synovial folds were found in most joints in both groups except for the posterior median atlantoaxial joints. Most of synovial folds were crescent-shaped, distributed on the superior aspects of the anterior median atlantoaxial joints, or in the antero-lateral aspects of the atlantooccipital joints and the lateral atlantoaxial joints. Compared to the adult group, the child group had a higher incidence of synovial folds (72.5% joints). The adult incidence was found to be 58.5%. 54.3% of the synovial folds in child were medium size or large size, but only 30.1% of the synovial folds in adult were medium size and there were no large ones. Microscopically, there were three histologic types synovial folds in these cervical joints, and 78.9% of them belonged to adipose type or fibro-adipose type in child, but only 45.8% belonged to the two types in adult. Our data suggest that the larger synovial folds in children may predispose them to an increased rate of entrapment with resultant edema and subluxation of the associated joint complex. This may be the cause why some cervical spine diseases preferentially take place in children rather than in adult, such as benign paroxysmal torticollis'atlantoaxial rotatory deformity and Grisel's syndrome.

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 85%

Section: Introductionmentioning

confidence: 96%

See 1 more Smart Citation

Anatomic study of the synovial folds of the occipito‐atlanto‐axial joints

Tang¹,

Liu²,

Yang³

et al. 2006

Clinical Anatomy

View full text Add to dashboard Cite

show abstract

“…Its aetiology is thought to be related to capsular or ligament laxity of the atlanto-axial joint secondary to inflammation or trauma [4,5]. The principal stabilising ligament of this joint is the transverse ligament, which prevents excessive anterior shift of C1 on C2.…”

Section: Introductionmentioning

confidence: 99%

Three-dimensional spiral CT scanning in children with acute torticollis

Nicholson

Higgins

Forgarty

et al. 1999

International Orthopaedics

View full text Add to dashboard Cite

“…In the acute phase, muscle spasm, capsular or ligamentous interposition, or bony interlocking, are all possible causes. 33 In the chronic phase ankylosis of the lateral masses would appear to be a contributing factor.…”

mentioning

confidence: 99%

Spinal canal capacity in simulated displacements of the atlantoaxial segment

Tucker

Taylor

1998

The Journal of Bone and Joint Surgery. British volume

View full text Add to dashboard Cite

In normal, physiological circumstances there is ample room in the spinal canal to accommodate the spinal cord. Our study aimed to identify the degree of compromise of the spinal canal which could be anticipated in various atlantoaxial pathological states. We examined paired atlas and axis vertebrae using high-definition radiography and simultaneous photography in both normal and simulated pathological orientations in order to measure the resultant dimension of the spinal canal and its percentage occlusion.At the extreme of physiological axial rotation (47°) the spinal canal is reduced to 61% of its cross-sectional area in neutral rotation. The spinal cord is thus safe from compromise.Atlantoaxial subluxation of up to 9 mm reduces the area of the spinal canal, in neutral rotation, to 60% with no cord compromise. Any rotation is, however, likely to cause cord compression.The mechanism of fixation in atlantoaxial rotatory subluxation could be explained by bony interlocking of the facet joint, reproducible in dry bones.

show abstract

Pathomechanism of Atlantoaxial Rotatory Fixation in Children

Cited by 87 publications

References 0 publications

Anatomic study of the synovial folds of the occipito‐atlanto‐axial joints

Anatomic study of the synovial folds of the occipito‐atlanto‐axial joints

Three-dimensional spiral CT scanning in children with acute torticollis

Spinal canal capacity in simulated displacements of the atlantoaxial segment

Contact Info

Product

Resources

About