Surgery of atlantoaxial osteoarthritis.

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-09-24 DOI:10.1016/j.wneu.2025.124507

Heta Räisänen, Antti Ronkainen, Juhana Frösen, Tuomo Thesleff

{"title":"Surgery of atlantoaxial osteoarthritis.","authors":"Heta Räisänen, Antti Ronkainen, Juhana Frösen, Tuomo Thesleff","doi":"10.1016/j.wneu.2025.124507","DOIUrl":null,"url":null,"abstract":"Background: Unilateral atlantoaxial osteoarthritis (AAOA) is an underdiagnosed condition characterised by severe occipitocervical pain and restricted head rotation. This study aimed to compare clinical outcomes and complications associated with different surgical methods used to treat AAOA in cases where conservative management fails.Methods: This was a retrospective cohort study conducted at Tampere University Hospital, Finland, with patients treated between 2004 and 2024. Patients were divided into two groups based on the surgical approach. Clinical outcomes were evaluated at a median follow-up of 60 days postoperatively, with a focus on pain reduction and complication rates. The study included 49 patients diagnosed with unilateral AAOA who underwent either C1-2 fixation with or without C2 nerve root decompression (group 1) or only C2 nerve root decompression (group 2).Results: Both groups showed substantial pain reduction with good or excellent outcomes in 82.3 % in group 1 and 73.3 % in group 2. Complications were more common in group 1 (29.4 %) than in group 2 (13.3 %), with sensory loss in the C2 dermatome being the most frequent complication.Conclusions: These findings suggest that both C1-2 fixation and C2 nerve root decompression are safe and effective methods for pain caused by AAOA, the later especially when symptoms are related to C2 radiculopathy.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"124507"},"PeriodicalIF":2.1000,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2025.124507","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Unilateral atlantoaxial osteoarthritis (AAOA) is an underdiagnosed condition characterised by severe occipitocervical pain and restricted head rotation. This study aimed to compare clinical outcomes and complications associated with different surgical methods used to treat AAOA in cases where conservative management fails.

Methods: This was a retrospective cohort study conducted at Tampere University Hospital, Finland, with patients treated between 2004 and 2024. Patients were divided into two groups based on the surgical approach. Clinical outcomes were evaluated at a median follow-up of 60 days postoperatively, with a focus on pain reduction and complication rates. The study included 49 patients diagnosed with unilateral AAOA who underwent either C1-2 fixation with or without C2 nerve root decompression (group 1) or only C2 nerve root decompression (group 2).

Results: Both groups showed substantial pain reduction with good or excellent outcomes in 82.3 % in group 1 and 73.3 % in group 2. Complications were more common in group 1 (29.4 %) than in group 2 (13.3 %), with sensory loss in the C2 dermatome being the most frequent complication.

Conclusions: These findings suggest that both C1-2 fixation and C2 nerve root decompression are safe and effective methods for pain caused by AAOA, the later especially when symptoms are related to C2 radiculopathy.

查看原文本刊更多论文

寰枢骨关节炎的外科治疗。

背景：单侧寰枢骨关节炎（AAOA）是一种未确诊的疾病，其特征是严重的枕颈疼痛和头部旋转受限。本研究旨在比较在保守治疗失败的情况下，不同手术方法治疗AAOA的临床结果和并发症。方法：这是一项在芬兰坦佩雷大学医院进行的回顾性队列研究，患者在2004年至2024年期间接受治疗。根据手术入路将患者分为两组。术后中位随访60天评估临床结果，重点关注疼痛减轻和并发症发生率。本研究纳入49例诊断为单侧AAOA的患者，接受C1-2固定伴或不伴C2神经根减压（1组）或仅伴C2神经根减压（2组）。结果：两组患者均有明显的疼痛减轻，其中组1为82.3%，组2为73.3%。并发症发生率1组（29.4%）高于2组（13.3%），其中C2皮节感觉丧失是最常见的并发症。结论：C1-2固定和C2神经根减压是治疗AAOA引起疼痛的安全有效的方法，特别是当症状与C2神经根病有关时。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS