Kim Jisu, Kim Youngjune, Lee Eugene, Lee Joon Woo
J Korean Soc Radiol. 2024 Jul;85(4):754-768. doi: 10.3348/jksr.2023.0104. Epub 2023 Dec 26.
To identify clinical and MR predictors of retro-odontoid pseudotumor (ROP) regression after posterior fixation in patients with atlantoaxial instability.
We included patients who had undergone posterior fixation for atlantoaxial instability and preoperative and postoperative MR imaging. Patients were classified into two groups according to the degree of ROP regression after posterior fixation: regression (≥ 10% reduction) and no regression (< 10% reduction). Mann-Whitney and Fisher's exact tests were performed to identify the clinical (age and sex) and MR predictors (preoperative ROP thickness, ROP type, MR signal homogeneity of the ROP, spinal cord signal change, spinal cord atrophy, ossified posterior longitudinal ligament, os odontoideum, and atlantodental interval) associated with ROP regression.
We retrospectively assessed 11 consecutive patients (7 female; median age, 66 years [range, 31-84 years]). Posterior fixation induced ROP regression in eight (72.7%) patients. Older age and greater preoperative ROP thickness significantly correlated with ROP regression ( = 0.024 and 0.012, respectively). All patients with preoperative ROP thickness > 5 mm exhibited ROP regression. The other variables were not significantly associated with ROP regression.
Older age and thicker preoperative ROP are associated with ROP regression after posterior fixation in patients with atlantoaxial instability.
确定寰枢椎不稳患者后路固定术后齿突后假瘤（ROP）消退的临床和磁共振成像（MR）预测因素。
我们纳入了接受寰枢椎不稳后路固定术以及术前行MR成像和术后行MR成像的患者。根据后路固定术后ROP消退程度将患者分为两组：消退组（减少≥10%）和未消退组（减少<10%）。采用曼-惠特尼检验和费舍尔精确检验来确定与ROP消退相关的临床（年龄和性别）和MR预测因素（术前ROP厚度、ROP类型、ROP的MR信号均匀性、脊髓信号变化、脊髓萎缩、后纵韧带骨化、齿突骨和寰齿间距）。
我们回顾性评估了11例连续患者（7例女性；中位年龄66岁[范围31 - 84岁]）。后路固定使8例（72.7%）患者的ROP消退。年龄较大和术前ROP厚度较大与ROP消退显著相关（分别为P = 0.024和P = 0.012）。所有术前ROP厚度>5 mm的患者均出现ROP消退。其他变量与ROP消退无显著相关性。
年龄较大和术前ROP较厚与寰枢椎不稳患者后路固定术后ROP消退相关。
