New radiographic index for occipito-cervical instability

Moon Soo Park, Seong Hwan Moon, Tae Hwan Kim, Jae Keun Oh, Ji Hoon Nam, Jae Kyun Jung, K. Daniel Riew

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Design: Retrospective study. Purpose: To propose a new radiographic index for occipito-cervical instability. Overview of Literature: Symptomatic atlanto-occipital instability requires the fusion of the atlanto-occipital joint. However, measurements of occipito-cervical translation using the Wiesel-Rothman technique, Power's ratio, and basion-axial interval are unreliable because the radiologic landmarks in the occipito-cervical junction lack clarity in radiography. Methods: One hundred four asymptomatic subjects were evaluated with lateral cervical radiographs in neutral, flexion and extension. They were stratified by age and included 52 young (20-29 years) and 52 middle-aged adults (50-59 years). The four radiographic reference points were posterior edge of hard palate (hard palate), posteroinferior corner of the most posterior upper molar tooth (molar), posteroinferior corner of the C1 anterior ring (posterior C1), and posteroinferior corner of the C2 vertebral body (posterior C2). The distance from posterior C1 and posterior C2 to the above anatomical landmarks was measured to calculate the range of motion (ROM) on dynamic radiographs. To determine the difference between the two age groups, unpaired t -tests were used. The statistical significance level was set at p < 0.05. Results: The ROM was 4.8±7.3 mm between the hard palate and the posterior C1, 9.9±10.2 mm between the hard palate and the posterior C2, 1.7±7.2 mm between the molar to the posterior C1, and 10.4±12.1 mm between the molar to the posterior C2. There was no statistically significant difference for the ROM between the young- and the middle-aged groups. The intra-observer reliability for new radiographic index was good. The inter-observer reliability for the ROM measured by the hard palate was low, but was better than that by the molar. Conclusions: ROM measured by the hard palate might be a useful new radiographic index in cases of occipito-cervical instability.

Original languageEnglish
Pages (from-to)123-128
Number of pages6
JournalAsian Spine Journal
Volume10
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

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Hard Palate
Articular Range of Motion
Atlanto-Occipital Joint
Radiography
Tooth
Retrospective Studies
Age Groups

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Park, M. S., Moon, S. H., Kim, T. H., Oh, J. K., Nam, J. H., Jung, J. K., & Riew, K. D. (2016). New radiographic index for occipito-cervical instability. Asian Spine Journal, 10(1), 123-128. https://doi.org/10.4184/asj.2016.10.1.123
Park, Moon Soo ; Moon, Seong Hwan ; Kim, Tae Hwan ; Oh, Jae Keun ; Nam, Ji Hoon ; Jung, Jae Kyun ; Riew, K. Daniel. / New radiographic index for occipito-cervical instability. In: Asian Spine Journal. 2016 ; Vol. 10, No. 1. pp. 123-128.
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abstract = "Study Design: Retrospective study. Purpose: To propose a new radiographic index for occipito-cervical instability. Overview of Literature: Symptomatic atlanto-occipital instability requires the fusion of the atlanto-occipital joint. However, measurements of occipito-cervical translation using the Wiesel-Rothman technique, Power's ratio, and basion-axial interval are unreliable because the radiologic landmarks in the occipito-cervical junction lack clarity in radiography. Methods: One hundred four asymptomatic subjects were evaluated with lateral cervical radiographs in neutral, flexion and extension. They were stratified by age and included 52 young (20-29 years) and 52 middle-aged adults (50-59 years). The four radiographic reference points were posterior edge of hard palate (hard palate), posteroinferior corner of the most posterior upper molar tooth (molar), posteroinferior corner of the C1 anterior ring (posterior C1), and posteroinferior corner of the C2 vertebral body (posterior C2). The distance from posterior C1 and posterior C2 to the above anatomical landmarks was measured to calculate the range of motion (ROM) on dynamic radiographs. To determine the difference between the two age groups, unpaired t -tests were used. The statistical significance level was set at p < 0.05. Results: The ROM was 4.8±7.3 mm between the hard palate and the posterior C1, 9.9±10.2 mm between the hard palate and the posterior C2, 1.7±7.2 mm between the molar to the posterior C1, and 10.4±12.1 mm between the molar to the posterior C2. There was no statistically significant difference for the ROM between the young- and the middle-aged groups. The intra-observer reliability for new radiographic index was good. The inter-observer reliability for the ROM measured by the hard palate was low, but was better than that by the molar. Conclusions: ROM measured by the hard palate might be a useful new radiographic index in cases of occipito-cervical instability.",
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Park, MS, Moon, SH, Kim, TH, Oh, JK, Nam, JH, Jung, JK & Riew, KD 2016, 'New radiographic index for occipito-cervical instability', Asian Spine Journal, vol. 10, no. 1, pp. 123-128. https://doi.org/10.4184/asj.2016.10.1.123

New radiographic index for occipito-cervical instability. / Park, Moon Soo; Moon, Seong Hwan; Kim, Tae Hwan; Oh, Jae Keun; Nam, Ji Hoon; Jung, Jae Kyun; Riew, K. Daniel.

In: Asian Spine Journal, Vol. 10, No. 1, 01.01.2016, p. 123-128.

Research output: Contribution to journalArticle

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T1 - New radiographic index for occipito-cervical instability

AU - Park, Moon Soo

AU - Moon, Seong Hwan

AU - Kim, Tae Hwan

AU - Oh, Jae Keun

AU - Nam, Ji Hoon

AU - Jung, Jae Kyun

AU - Riew, K. Daniel

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N2 - Study Design: Retrospective study. Purpose: To propose a new radiographic index for occipito-cervical instability. Overview of Literature: Symptomatic atlanto-occipital instability requires the fusion of the atlanto-occipital joint. However, measurements of occipito-cervical translation using the Wiesel-Rothman technique, Power's ratio, and basion-axial interval are unreliable because the radiologic landmarks in the occipito-cervical junction lack clarity in radiography. Methods: One hundred four asymptomatic subjects were evaluated with lateral cervical radiographs in neutral, flexion and extension. They were stratified by age and included 52 young (20-29 years) and 52 middle-aged adults (50-59 years). The four radiographic reference points were posterior edge of hard palate (hard palate), posteroinferior corner of the most posterior upper molar tooth (molar), posteroinferior corner of the C1 anterior ring (posterior C1), and posteroinferior corner of the C2 vertebral body (posterior C2). The distance from posterior C1 and posterior C2 to the above anatomical landmarks was measured to calculate the range of motion (ROM) on dynamic radiographs. To determine the difference between the two age groups, unpaired t -tests were used. The statistical significance level was set at p < 0.05. Results: The ROM was 4.8±7.3 mm between the hard palate and the posterior C1, 9.9±10.2 mm between the hard palate and the posterior C2, 1.7±7.2 mm between the molar to the posterior C1, and 10.4±12.1 mm between the molar to the posterior C2. There was no statistically significant difference for the ROM between the young- and the middle-aged groups. The intra-observer reliability for new radiographic index was good. The inter-observer reliability for the ROM measured by the hard palate was low, but was better than that by the molar. Conclusions: ROM measured by the hard palate might be a useful new radiographic index in cases of occipito-cervical instability.

AB - Study Design: Retrospective study. Purpose: To propose a new radiographic index for occipito-cervical instability. Overview of Literature: Symptomatic atlanto-occipital instability requires the fusion of the atlanto-occipital joint. However, measurements of occipito-cervical translation using the Wiesel-Rothman technique, Power's ratio, and basion-axial interval are unreliable because the radiologic landmarks in the occipito-cervical junction lack clarity in radiography. Methods: One hundred four asymptomatic subjects were evaluated with lateral cervical radiographs in neutral, flexion and extension. They were stratified by age and included 52 young (20-29 years) and 52 middle-aged adults (50-59 years). The four radiographic reference points were posterior edge of hard palate (hard palate), posteroinferior corner of the most posterior upper molar tooth (molar), posteroinferior corner of the C1 anterior ring (posterior C1), and posteroinferior corner of the C2 vertebral body (posterior C2). The distance from posterior C1 and posterior C2 to the above anatomical landmarks was measured to calculate the range of motion (ROM) on dynamic radiographs. To determine the difference between the two age groups, unpaired t -tests were used. The statistical significance level was set at p < 0.05. Results: The ROM was 4.8±7.3 mm between the hard palate and the posterior C1, 9.9±10.2 mm between the hard palate and the posterior C2, 1.7±7.2 mm between the molar to the posterior C1, and 10.4±12.1 mm between the molar to the posterior C2. There was no statistically significant difference for the ROM between the young- and the middle-aged groups. The intra-observer reliability for new radiographic index was good. The inter-observer reliability for the ROM measured by the hard palate was low, but was better than that by the molar. Conclusions: ROM measured by the hard palate might be a useful new radiographic index in cases of occipito-cervical instability.

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