Cargando…
The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients
STUDY DESIGN: Retrospective analysis of prospectively collected data. PURPOSE: To describe the radiological characteristics of the occipitocervical area in patients with ankylosing spondylitis (AS) using the novel measure X-angle and to describe the correlation between the ankylosed occipitoatlantoa...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Society of Spine Surgery
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365776/ https://www.ncbi.nlm.nih.gov/pubmed/30326690 http://dx.doi.org/10.31616/asj.2018.0010 |
_version_ | 1783393481421488128 |
---|---|
author | Manabe, Nodoka Covaro, Augusto Bobinski, Lukas Shimizu, Takachika Olerud, Claes Robinson, Yohan |
author_facet | Manabe, Nodoka Covaro, Augusto Bobinski, Lukas Shimizu, Takachika Olerud, Claes Robinson, Yohan |
author_sort | Manabe, Nodoka |
collection | PubMed |
description | STUDY DESIGN: Retrospective analysis of prospectively collected data. PURPOSE: To describe the radiological characteristics of the occipitocervical area in patients with ankylosing spondylitis (AS) using the novel measure X-angle and to describe the correlation between the ankylosed occipitoatlantoaxial (OAA) joint and thoracic kyphosis (TK). OVERVIEW OF LITERATURE: AS affects the axial skeleton, leading to progressive ankylosis of all vertebral segments. The effect of ankylosis on the upper cervical area of these patients is not well documented. METHODS: All patients with complete ankylosis of the spinal column between C3 and T1, treated for cervical spinal fracture between 2007 and 2014, were eligible for inclusion in this study. The level of cervical fracture was identified. The T1–12 and T5–12 angles were measured using preoperative lateral radiography. The progressive degeneration of the C0-C1-C2 joints was evaluated via the new indicator X-angle, through the measurement of the angle of the C0-C1-C2 articulations in the coronal plane using computed tomography. RESULTS: We included 86 consecutive patients with AS (67 males) aged 69±12 years. The patients were divided into two groups according to the degenerative change in the C0–C1 joint (62 patients with a mobile joint and 24 patients with an ankylosed joint). There was no significant difference between the two groups in terms of age (p =0.094) and level of fracture (p =0.949). The most commonly affected level was C6. There was no requirement for revision due to non-union in any of the patients. There was a statistically significant difference observed in the T1–12, T5–12, and X-angles (p =0.004, 0.001, and <0.001, respectively). TK was greater in the ankylosed joint group than in the mobile joint group. The X-angle was also greater in the ankylosed joint group because of the vertical destruction of the OAA joint. CONCLUSIONS: Thoracic hyperkyphosis resulted in degenerative changes in the C0-C1-C2 joint in patients with AS. The X-angle is a reliable method for measuring the integrity of the C0-C1-C2 joint in such patients. |
format | Online Article Text |
id | pubmed-6365776 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-63657762019-02-08 The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients Manabe, Nodoka Covaro, Augusto Bobinski, Lukas Shimizu, Takachika Olerud, Claes Robinson, Yohan Asian Spine J Clinical Study STUDY DESIGN: Retrospective analysis of prospectively collected data. PURPOSE: To describe the radiological characteristics of the occipitocervical area in patients with ankylosing spondylitis (AS) using the novel measure X-angle and to describe the correlation between the ankylosed occipitoatlantoaxial (OAA) joint and thoracic kyphosis (TK). OVERVIEW OF LITERATURE: AS affects the axial skeleton, leading to progressive ankylosis of all vertebral segments. The effect of ankylosis on the upper cervical area of these patients is not well documented. METHODS: All patients with complete ankylosis of the spinal column between C3 and T1, treated for cervical spinal fracture between 2007 and 2014, were eligible for inclusion in this study. The level of cervical fracture was identified. The T1–12 and T5–12 angles were measured using preoperative lateral radiography. The progressive degeneration of the C0-C1-C2 joints was evaluated via the new indicator X-angle, through the measurement of the angle of the C0-C1-C2 articulations in the coronal plane using computed tomography. RESULTS: We included 86 consecutive patients with AS (67 males) aged 69±12 years. The patients were divided into two groups according to the degenerative change in the C0–C1 joint (62 patients with a mobile joint and 24 patients with an ankylosed joint). There was no significant difference between the two groups in terms of age (p =0.094) and level of fracture (p =0.949). The most commonly affected level was C6. There was no requirement for revision due to non-union in any of the patients. There was a statistically significant difference observed in the T1–12, T5–12, and X-angles (p =0.004, 0.001, and <0.001, respectively). TK was greater in the ankylosed joint group than in the mobile joint group. The X-angle was also greater in the ankylosed joint group because of the vertical destruction of the OAA joint. CONCLUSIONS: Thoracic hyperkyphosis resulted in degenerative changes in the C0-C1-C2 joint in patients with AS. The X-angle is a reliable method for measuring the integrity of the C0-C1-C2 joint in such patients. Korean Society of Spine Surgery 2019-02 2018-10-18 /pmc/articles/PMC6365776/ /pubmed/30326690 http://dx.doi.org/10.31616/asj.2018.0010 Text en Copyright © 2019 by Korean Society of Spine Surgery This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Manabe, Nodoka Covaro, Augusto Bobinski, Lukas Shimizu, Takachika Olerud, Claes Robinson, Yohan The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title | The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title_full | The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title_fullStr | The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title_full_unstemmed | The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title_short | The Relationship between the Occipitocervical Junction and Thoracic Kyphosis in Ankylosing Spondylitis: A Retrospective Cohort Study of 86 Cervical Fractures in Surgically Treated Patients |
title_sort | relationship between the occipitocervical junction and thoracic kyphosis in ankylosing spondylitis: a retrospective cohort study of 86 cervical fractures in surgically treated patients |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6365776/ https://www.ncbi.nlm.nih.gov/pubmed/30326690 http://dx.doi.org/10.31616/asj.2018.0010 |
work_keys_str_mv | AT manabenodoka therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT covaroaugusto therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT bobinskilukas therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT shimizutakachika therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT olerudclaes therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT robinsonyohan therelationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT manabenodoka relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT covaroaugusto relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT bobinskilukas relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT shimizutakachika relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT olerudclaes relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients AT robinsonyohan relationshipbetweentheoccipitocervicaljunctionandthoracickyphosisinankylosingspondylitisaretrospectivecohortstudyof86cervicalfracturesinsurgicallytreatedpatients |