BACKGROUND Chronic atlantoaxial anterior dislocation (AAD) not only results in myelopathy, but dislocation-related kyphosis also results in cervical malalignment, which permanently affects neck function and patient-reported outcomes (PROs). OBJECTIVE To investigate the effect of kyphotic correction on realigning cervical spine and independent cervical alignment parameters, which may be correlated with an improvement of PROs. METHODS The study included 21 patients with chronic AAD-related kyphosis who underwent C1-2 reduction and correction surgery. Radiographic parameters were measured to assess cervical realignment preoperatively and postoperatively. Neck disability index (NDI), short form 12 physical component summary (SF-12 PCS), and Japanese Orthopaedic Association (JOA) scores were recorded to reveal changes in PROs. The independent parameters correlated with the improvements of PROs were analyzed. RESULTS Of the radiographic parameters, the C1-2 Cobb angle, the C2-7 Cobb angle, thoracic inlet angle, cervical tilt, and T1 slope were significantly changed from -4.0° ± 16.2°, -29.2°± 11.2°, 73.1°± 13.3°, 30.4°± 8.5°, and 29.1°± 8.8°preoperatively to -13.5°± 8.1°(P =.005), -18.0°± 12.0°(P <.001), 67.1°± 11.6°(P =.042), 23.1°± 10.3°(P =.007), and 24.0°± 7.0°(P =.011) at last follow-up, respectively. NDI, JOA, and SF-12 PCS scores were significantly improved postoperatively. The C1-2 Cobb angle was an independent parameter correlated with the improvements in SF-12 PCS, NDI, and JOA scores. CONCLUSION Correction and reduction surgery can realign cervical spine in chronic AAD patients. The C1-2 Cobb angle was an independent parameter correlated with the improvements of PROs.
Bibliographical noteFunding Information:
The present study was financially supported by the grants of China Scholarship Council (2017-3109/201708260068), National Natural Science Foundation of China (81460405), 5511 Innovation-driven Program of Jiangxi Province Department of Science and Technology (20165BCB18017), and Key Program of Jaingxi Provincial Department of Science and Technology (20152ACB21024). The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.
© 2018 by the Congress of Neurological Surgeons.
All Science Journal Classification (ASJC) codes
- Clinical Neurology