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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Daimon Shiraishi (Department of Neurosurgery Nagoya University Hospital) Yusuke Nishimura (Department of Neurosurgery Nagoya University Hospital) Isaac Aguirre-Carreno (Division of Neurosurgery St. Michael’s Hospital University of Toronto) Masahito Hara (Department of Neurosurgery Aichi Medical University Hospital) Satoshi Yoshikawa (Department of Neurosurgery Nagoya University Hospital) Kaoru Eguchi (Department of Neurosurgery Nagoya University Hospital) Yoshitaka Nagashima (Department of Neurosurgery Nagoya University Hospital) Hiroshi Ito (Department of Neurosurgery Nagoya University Hospital) Shoichi Haimoto (Department of Neurosurgery Nagoya University Hospital) Yu Yamamoto (Department of Neurosurgery Inazawa Manucipal Hospital) Howard J. Ginsberg (Department of Neurosurgery Inazawa Manucipal Hospital) Masakazu Takayasu (Department of Neurosurgery Aichi Medical University Hospital) Ryuta Saito (Department of Neurosurgery Nagoya University Hospital)
저널정보
대한척추신경외과학회 Neurospine Neurospine 제18권 제4호
발행연도
2021.12
수록면
741 - 748 (8page)
DOI
10.14245/ns.2142860.430

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Objective: The purpose of this study is to find the clinical and radiographic characteristics of traumatic craniocervical junction (CCJ) injuries requiring occipitocervical fusion (OC fusion) for early diagnosis and surgical intervention. Methods: We retrospectively reviewed 12 patients with CCJ injuries presenting to St. Michaels Hospital in Toronto who underwent OC fusion and looked into the following variables; (1) initial trauma data on emergency room arrival, (2) associated injuries, (3) imaging characteristics of computed tomography (CT) scan and magnetic resonance imaging (MRI), (4) surgical procedures, surgical complications, and neurological outcome. Results: All patients were treated as acute spinal injuries and underwent OC fusion on an emergency basis. Patients consisted of 10 males and 2 females with an average age of 47 years (range, 18?82 years). All patients sustained high-energy injuries. Three patients out of 6 patients with normal BAI (basion-axial interval) and BDI (basion-dens interval) values showed visible CCJ injuries on CT scans. However, the remaining 3 patients had no clear evidence of occipitoatlantal instability on CT scans. MRI clearly described several findings indicating occipitoatlantal instability. The 8 patients with normal values of ADI (atlanto-dens interval interval) demonstrated atlantoaxial instability on CT scan, however, all MRI more clearly and reliably demonstrated C1/2 facet injury and/or cruciate ligament injury. Conclusion: We advocate measures to help recognize CCJ injury at an early stage in the present study. Occipitoatlantal instability needs to be carefully investigated on MRI in addition to CT scan with special attention to facet joint and ligament integrity.
#Craniocervical junction injuries #Occipitocervical fusion #Ligament injury #High-energy injuries #Magnetic resonance imaging

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참고문헌 (37)

참고문헌 신청
Bellabarba C / 2006 / Diagnosis and treatment of craniocervical dislocation in a series of 17 consecutive survivors during an 8-year period / J Neurosurg Spine 4:429~440 google schola DiBenedetto T / 1990 / Traumatic atlanto-occipital instability. A case report with follow-up and a new diagnostic technique / Spine 15:595~597 google schola Nidecker AE / 2016 / Magnetic resonance imaging of the craniovertebral junction ligaments : normal anatomy and traumatic injury / J Neurol Surg B Skull Base 77:388~395 google schola Ali J / 1992 / The Advanced Trauma Life Support course for senior medical students / Can J Surg 35:541~545 google schola Martinez-Del-Campo E / 2016 / Computed tomography parameters for atlantooccipital dislocation in adult patients : the occipital condyle-C1 interval / J Neurosurg Spine 24:535~545 google schola

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