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| Value of multi-slice CT in measurement of cervico-occipital bone diameter before and after surgery for#br#
basilar invagination with atlantoaxial dislocation |
| DAI Wei-ying, TIAN Chao, YANG Tian-hao, REN Tao |
| Department of Radiology, Huan Hu Hospital, Tianjin 300350, China |
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Abstract Objective: To explore the value of MSCT in evaluating the surgical effect of adult basilar invagination with atlantoaxial dislocation. Methods: Thirty-seven patients with basilar invagination and atlantoaxial dislocation underwent imaging examination before and after operation. MSCT three-dimensional reconstructed images were analyzed. According to the presence or absence of syringomyelia(SM), the patients were divided into two groups(group A without SM, group B with SM). The data of basion-dens interval(BDI), atlanto-dental interval(ADI), space available for the spinal cord(SAC), clivus-canal angle(CCA), highly index(HI), and chamberlain line(CBL) of the occipitocervical were obtained by craniometry. The differences of these parameters before and after operation were compared, and the correlation between these parameters and the clinical effect were analyzed. Results: In group A, the BDI, ADI, SAC, CCA, HI and CBL before and after operation were 12.6 mm, 8.3 mm, 4.5 mm, 3.3 mm, 18.2 mm, 20.8 mm, 138.3°, 150.4°, 28.7 mm, 43.4 mm, 6.3 mm, 3.3 mm respectively, and the JOA scores were 8.87 points and 12.6 points before and after surgery, with statistical difference(P<0．05)． There were 12 effective cases and 3 stable cases after surgery in group A, the JOA scores before and after operation were significantly correlated with each index(r=-0.667, -0.673, -0.771, -0.719, 0.682, 0.625, 0.595, 0.658, 0.787, 0.696, -0.647, -0.796; P<0．05)． In group B, the BDI, ADI, SAC, CCA, HI and CBL before and after surgery were 12.2 mm, 8.6 mm, 5.9 mm, 3.1 mm, 16.3 mm, 17.6 mm, 136.8°, 150.2°, 32.3 mm, 41.5 mm, 8.7 mm, 4.8 mm respectively, and the JOA scores were 9.59 points and 13.59 points before and after surgery, with statistical difference(P<0．05)． There were 20 effective cases and 2 stable cases after surgery in group B, and JOA scores before and after operation were significantly correlated with each index(r=-0.756, -0.728, -0.651, -0.619, 0.684, 0.672, 0.726、0.695, 0.578, 0.632, -0.748, -0.821 respectively, P<0．05)． Conclusion: MSCT measurement is helpful to understand the changes of bone structure before and after operation, and can be used to judge the curative effect.
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Received: 10 December 2018
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[1]袁慧敏，武春明，刘佳欢，等. 颅底凹陷症的临床研究进展[J]. 中医正骨，2016，12（28）：42-45.
[2]Klekamp J. Treatment of basilar invagination[J]. Eur Spine J, 2014, 23(8): 1656-1665.
[3]Smith JS, Shaffrey CI, Abel MF, et al. Basilar Invagination Neurosurg, 2010, 66(3): 39-47.
[4]Tong H, Yu X, Guo S. Letter: Distraction, Compression, and Extension Reduction of Basilar Invagination and Atlantoaxial Dislocation[J]. Neurosurgery, 2015, 76(2): E239-E240.
[5]徐韬，买尔旦·买买提，甫拉提·买买提，等. 颅底凹陷症的分型及外科治疗[J]. 中华骨科杂志，2015，35（5）：518-526.
[6]Chaudhry NS, Ozpinar A, Bi WL, et al. Basilar Invagination: Case Report and Literature Review[J]. World Neurosurg, 2015, 83(6): 1180. e7-11.
[7]刘鑫，孙兆忠. 颅底凹陷症影像学特点及手术策略研究进展[J]. 滨州医学院学报，2017，40（8）：291-293.
[8]程飞，朱坤，许刚，等. 颅底凹陷症伴寰枢椎脱位的研究进展[J]. 临床骨科杂志，2017，20（4）：507-511.
[9]Pinter NK, Mcvige J, MeChtler I. Basilar invagination, basilar impression, and platybasia: clinical and imaging aspects[J]. Curr Pain Headache Rep, 2016, 20(8): 1-8.
[10]吴昕峰，田伟，安岩，等. 上颈椎畸形不稳定后路手术中斜坡-枢椎角与疗效的相关性研究[J]. 中华骨科杂志，2015，35（5）：511-517.
[11]Goel A. Basilar invagination, Chiari malformation, syringomyelia: a review[J]. Neurol India, 2009, 57: 235-246.
[12]范涛，侯哲，赵新岗，等. 先天性颅底凹陷症的临床分型及手术治疗体会（附103例报告）[J]. 中华神经外科杂志，2014，30（7）：658-662.
[13]王达义，常巍，尚晖，等. 经口咽前路控制性松解复位+后路枕颈融合内固定术治疗颅底凹陷症[J]. 骨科，2015，6（4）：177-182.
[14]Meng Y, Chen H, Lou J, et al. Posterior distraction reduction and occipitocervical fixation for the treatment of basilar invagination and atlantoaxial dislocation[J]. Clin Neurol Neurosurg, 2016, 140: 60-67. |
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2019, Vol. 30 
