Clinical features and outcomes of basilar invagination.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY
Maoyang Qi, Yueqi Du, Boyan Zhang, Hongfeng Meng, Tianyu Jin, Zong Xin, Can Zhang, Jialu Wang, Jiaxing Yu, Xuesong Bai, Wanru Duan, Zan Chen
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Abstract

Basilar invagination has been classified into two types by Goel: Type A is defined mechanical instability of the atlantoaxial joint with upward displacement of the odontoid process while Type B is characterized by stable atlantoaxial joints. This study reviews the association between radiological features and symptomatology and prognosis of two types of basilar invagination for better clinical management. A retrospective analysis was conducted including 141 patients diagnosed with basilar invagination who underwent surgical treatment from January 2016 to December 2020. The neurological function was assessed by the JOA scores, and Short-Form 12 scores. Logistic univariate and multivariate analyses were performed to predict prognostic risk factors. Type A patients (21/101, 20.8%) with more cases of dizziness, lower preoperative JOA scores and SF-12 PCS scores (JOA, 13.0 vs. 13.9, P = 0.042; SF-12 PCS, 37.48 vs. 38.42, P = 0.034) compared to type B (2/40, 5%) (P = 0.022). Type B (22/40, 55%) with more cases of ataxia than type A (35/101, 34.7%) (P = 0.026). Patients with type B demonstrated a significantly higher improvement rate in SF-12 PCS than type A (P = 0.018). Further logistic regression revealed that onset age ≥ 45 years (OR 4.654, 95% CI 1.645-13.165; p = 0.004) and basal angle ≥ 125° (OR 28.139, 95% CI 1.090-726.239; p = 0.044) were independent risk factors for type A and type B, respectively. Type A patients with more cases of dizziness, and type B patients with more cases of ataxia, can achieve better long-term prognosis following clinical intervention.

颅底凹陷的临床特点及预后。
Goel将基底内陷分为两种类型:A型定义为寰枢关节机械不稳定,齿状突向上移位;B型定义为寰枢关节稳定。本研究回顾了两种类型的颅底凹陷的影像学特征与症状和预后之间的关系,以便更好地进行临床治疗。回顾性分析2016年1月至2020年12月接受手术治疗的141例颅底凹陷患者。通过JOA评分和Short-Form 12评分评估神经功能。进行Logistic单因素和多因素分析来预测预后危险因素。A型患者(21/101,20.8%)头晕较多,术前JOA评分和SF-12 PCS评分较低(JOA, 13.0比13.9,P = 0.042;SF-12型(37.48 vs. 38.42, P = 0.034)与B型(2/ 40,5 %)相比(P = 0.022)。B型(22/40,55%)较A型(35/101,34.7%)有显著性差异(P = 0.026)。B型患者SF-12 PCS的改善率明显高于a型患者(P = 0.018)。进一步logistic回归显示发病年龄≥45岁(OR 4.654, 95% CI 1.645-13.165;p = 0.004),基底角≥125°(OR 28.139, 95% CI 1.090-726.239;p = 0.044)分别为A型和B型的独立危险因素。A型患者较多出现头晕,B型患者较多出现共济失调,经临床干预可获得较好的远期预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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