Cui Shengyu, Wang Xinyu, Li Kang, Feng Hailong, Liu Zhenlei, Jian Fengzeng, Wang Kai
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, People's Republic of China.
Spine Center, China International Neuroscience Institute (CHINA-INI), Beijing, People's Republic of China.
Ther Clin Risk Manag. 2024 Nov 26;20:789-797. doi: 10.2147/TCRM.S483075. eCollection 2024.
This study aims to establish a quantitative relationship between cervical lordosis (CL) and the rotation angle of the axis for the surgical reduction of atlantoaxial dislocation (AAD) and to explore the potential applications of this relationship in preoperative planning and selection of surgical techniques.
To construct the correlation between horizontal gaze and location of axis, we introduced the angle B, defined as the angle between the Frankfort horizontal line and the extension line of the posterior edge of the axis, and explored its application in surgical planning. We retrospectively analyzed imaging data from computed tomography of 23 AAD patients who had undergone posterior reduction and fixation. Theoretical equations were deduced through a series of angular transformations, and linear regression analysis was used to validate our findings.
Our results showed a strong linear relationship between the change in CL (ΔCL) and the change in B(ΔB) (y=-1.0402x, coefficient of determination R²=0.978, P<0.001), supporting our deduction that ΔCL=ΔB. Furthermore, we found that the rotation angle of the axis (angle D) was equal to ΔCL. By resolving the atlantoaxial interval into the vertical dimension (h) and horizontal dimension (d), we could calculate the maximum vertical and horizontal distance that the axis could move theoretically according to a patient's maximum ΔCL. This finding supports our theory that the introduction of angle B can provide more precise preoperative planning and surgical technique selection for patients with AAD.
By introducing angle B and deducing the equation ΔB=ΔCL=D, we have provided an innovative tool for preoperative planning and surgical technique selection for patients with AAD. This equation not only helps surgeons achieve more precise and effective surgical reductions but also emphasizes the important role of angle B in surgical planning.
本研究旨在建立颈椎前凸（CL）与寰枢椎脱位（AAD）手术复位时枢椎旋转角度之间的定量关系，并探讨这种关系在术前规划和手术技术选择中的潜在应用。
为构建水平注视与枢椎位置之间的相关性，我们引入了角度B，定义为法兰克福水平线与枢椎后缘延长线之间的夹角，并探讨其在手术规划中的应用。我们回顾性分析了23例接受后路复位固定的AAD患者的计算机断层扫描成像数据。通过一系列角度变换推导理论方程，并使用线性回归分析验证我们的发现。
我们的结果显示CL变化（ΔCL）与B变化（ΔB）之间存在很强的线性关系（y=-1.0402x，决定系数R²=0.978，P<0.001），支持我们的推断ΔCL=ΔB。此外，我们发现枢椎旋转角度（角度D）等于ΔCL。通过将寰枢椎间隙分解为垂直维度（h）和水平维度（d），我们可以根据患者的最大ΔCL理论计算枢椎理论上可以移动的最大垂直和水平距离。这一发现支持了我们的理论，即引入角度B可以为AAD患者提供更精确的术前规划和手术技术选择。
通过引入角度B并推导方程ΔB=ΔCL=D，我们为AAD患者的术前规划和手术技术选择提供了一种创新工具。该方程不仅有助于外科医生实现更精确有效的手术复位，还强调了角度B在手术规划中的重要作用。
