File Download

There are no files associated with this item.

  Links for fulltext
     (May Require Subscription)
Supplementary

Article: Radiographic assessment of segmental motion at the atlantoaxial junction in the Klippel-Feil patient

TitleRadiographic assessment of segmental motion at the atlantoaxial junction in the Klippel-Feil patient
Authors
KeywordsAtlantoaxial instability
Cervical spine
Congenital
Craniovertebral
Developmental
Fusion
Klippel-Feil syndrome
Radiographic
Issue Date2006
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2006, v. 31 n. 2, p. 171-177 How to Cite?
AbstractStudy Design. A retrospective review of 33 consecutive Klippel-Feil syndrome (KFS) patients at a single institution. Objectives. To assess in KFS patients the presence and degree of radiographic segmental motion at the atlanto-axial junction, factors contributing to such motion, and associated clinical manifestations. Summary of Background Data. Studies suggest that abnormal segmentation in KFS patients may result in cervical hypermobility, increasing the risk of developing neurologic compromise and the need for surgical intervention. The use of the anterior and posterior atlantodens interval (AADI/PADI) has gained interest as a method for assessing atlantoaxial instability and for space available for the cord. Although helpful for identifying instability after trauma, these measurements are not understood in KFS patients. In addition, the effects of the fusion process associated with KFS on atlantoaxial motion and associated clinical findings have not been properly addressed. Methods. Radiographs were analyzed for the presence of occipitalization, number/location of congenially fused segments, and the AADI and PADI. Results. There were 15 males and 18 females (mean age, 13.9 years). Occipitalization occurred in 48.5% of patients. A fused C2-C3 segment was noted in 72.7% of cases. More motion with respect to AADI was evident on O-C1 and C2-C3 fusion only patients, which were all asymptomatic. Overall, 24.2% of patients were symptomatic. Mean AADI and PADI difference was 2.0 mm (symptomatic: mean, 1.5 mm; asymptomatic: mean, 2.1 mm) and -1.7 mm (symptomatic: mean, -1.0 mm; asymptomatic: mean, -2.0 mm), respectively (P > 0.05). Conclusions. Hypermobility of the atlantoaxial junction, as indicated by increased AADI on flexion-extension radiographs, is not necessarily associated with an increased risk for the development of symptoms or neurologic signs in the KFS patient. Occipitalization plays an integral role in the degree of motion at the atlantoaxial region. Greatest AADI values were in patients with occipitalization and a fused C2-C3 segment. The presence of symptoms was not related to the degree of AADI change. Evaluation of the PADI provides additional information for identifying patients at risk for developing symptoms. Nonetheless, KFS patients remain largely asymptomatic. ©2006, Lippincott Williams & Wilkins, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/92925
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorShen, FHen_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorHerman, Jen_HK
dc.contributor.authorLubicky, JPen_HK
dc.date.accessioned2010-09-22T05:03:57Z-
dc.date.available2010-09-22T05:03:57Z-
dc.date.issued2006en_HK
dc.identifier.citationSpine, 2006, v. 31 n. 2, p. 171-177en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/92925-
dc.description.abstractStudy Design. A retrospective review of 33 consecutive Klippel-Feil syndrome (KFS) patients at a single institution. Objectives. To assess in KFS patients the presence and degree of radiographic segmental motion at the atlanto-axial junction, factors contributing to such motion, and associated clinical manifestations. Summary of Background Data. Studies suggest that abnormal segmentation in KFS patients may result in cervical hypermobility, increasing the risk of developing neurologic compromise and the need for surgical intervention. The use of the anterior and posterior atlantodens interval (AADI/PADI) has gained interest as a method for assessing atlantoaxial instability and for space available for the cord. Although helpful for identifying instability after trauma, these measurements are not understood in KFS patients. In addition, the effects of the fusion process associated with KFS on atlantoaxial motion and associated clinical findings have not been properly addressed. Methods. Radiographs were analyzed for the presence of occipitalization, number/location of congenially fused segments, and the AADI and PADI. Results. There were 15 males and 18 females (mean age, 13.9 years). Occipitalization occurred in 48.5% of patients. A fused C2-C3 segment was noted in 72.7% of cases. More motion with respect to AADI was evident on O-C1 and C2-C3 fusion only patients, which were all asymptomatic. Overall, 24.2% of patients were symptomatic. Mean AADI and PADI difference was 2.0 mm (symptomatic: mean, 1.5 mm; asymptomatic: mean, 2.1 mm) and -1.7 mm (symptomatic: mean, -1.0 mm; asymptomatic: mean, -2.0 mm), respectively (P > 0.05). Conclusions. Hypermobility of the atlantoaxial junction, as indicated by increased AADI on flexion-extension radiographs, is not necessarily associated with an increased risk for the development of symptoms or neurologic signs in the KFS patient. Occipitalization plays an integral role in the degree of motion at the atlantoaxial region. Greatest AADI values were in patients with occipitalization and a fused C2-C3 segment. The presence of symptoms was not related to the degree of AADI change. Evaluation of the PADI provides additional information for identifying patients at risk for developing symptoms. Nonetheless, KFS patients remain largely asymptomatic. ©2006, Lippincott Williams & Wilkins, Inc.en_HK
dc.languageengen_HK
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectAtlantoaxial instabilityen_HK
dc.subjectCervical spineen_HK
dc.subjectCongenitalen_HK
dc.subjectCraniovertebralen_HK
dc.subjectDevelopmentalen_HK
dc.subjectFusionen_HK
dc.subjectKlippel-Feil syndromeen_HK
dc.subjectRadiographicen_HK
dc.titleRadiographic assessment of segmental motion at the atlantoaxial junction in the Klippel-Feil patienten_HK
dc.typeArticleen_HK
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/01.brs.0000195347.35380.68en_HK
dc.identifier.pmid16418636-
dc.identifier.scopuseid_2-s2.0-30944459056en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-30944459056&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume31en_HK
dc.identifier.issue2en_HK
dc.identifier.spage171en_HK
dc.identifier.epage177en_HK
dc.identifier.eissn1528-1159-
dc.identifier.isiWOS:000234715300009-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridShen, FH=7201583245en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridHerman, J=7403275959en_HK
dc.identifier.scopusauthoridLubicky, JP=7004313450en_HK

Export via OAI-PMH Interface in XML Formats


OR


Export to Other Non-XML Formats