Home About Journal AHEAD OF PRINT Current Issue Back Issues Instructions Submission Search Subscribe Blog    

Users Online: 2216 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Year : 2018  |  Volume : 52  |  Issue : 2  |  Page : 190-195

Sagittal atlantoaxial joint inclination and reduction index values for diagnosis and treatment of irreducible atlantoaxial Dislocation

1 Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 26600, China
2 Department of Orthopaedic Surgery, Hanting People's Hospital of Weifang, Weifang 261100, China

Correspondence Address:
Dr. Yong-Ming Xi
Department of Spinal Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266003
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_251_16

Rights and Permissions

Background: Irreducible atlantoaxial dislocation (IAAD) is a disorder of atlantoaxial joint instability with various causes. The diagnostic criteria for IAAD are variable. The diagnosis of IAAD is mainly based on preoperative and intraoperative traction results, as well as the physician's experience, with no relatively uniform guidelines for the selection of treatment. This study evaluates sagittal atlantoaxial joint inclination (SAAJI) and reduction index (RI) values for diagnosis and treatment of IAAD. Materials and Methods: 24 IAAD patients treated in our hospital from January 2008 to July 2014 were retrospectively analysed. Patients included were 13 males and 11 females, with a mean age of 43 years. The various causes for IAAD were atlantoaxial transverse ligament rupture (n=3), old dens fracture (n=15), occipitalization of the atlas (n=6). The patients were divided into two groups. group A underwent anterior release with posterior reduction and fixation; Group B underwent posterior reduction and fixation; 12 healthy individuals served as controls. SAAJI and atlas-dens interval (ADI) values before and after traction were measured, and RI was calculated. Imaging data were analyzed. Results: The mean SAAJI values were as follows: left, 5.6 ± 1.9° and right, 5.1 ± 2.1° in the control group; right, 39.5 ± 6.0° and left, 38.8 ± 5.8° in Group A; and right, 23.1 ± 7.0° and left, 23.9 ± 6.1° in Group B. There was no significant difference in the SAAJI values of the three groups (P < 0.05). The mean RIs in Groups A and B were 17.6 ± 9.3% and 34.4 ± 5.2%, respectively, and the difference was statistically significant (P < 0.05). There were obvious negative correlations between the SAAJI and RI values in Groups A and B. Conclusions: SAAJI and RI can be used as important imaging indicators to determine the reversibility of IAAD. If the RI value is >27.9% and SAAJI value is <32.5°, reduction and fixation can be achieved by the posterior approach alone; otherwise, a combination of anterior and posterior approaches would be necessary.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded44    
    Comments [Add]    

Recommend this journal