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Article

Spontaneous Osseous Fusion after Remodeling Therapy for Chronic Atlantoaxial Rotatory Fixation and Recovery Mechanism of Rotatory Range of Motion of the Cervical Spine

1
Department of Orthopaedic Surgery, National Defense Medical College, Saitama 359-8513, Japan
2
Department of Orthopaedic Surgery, School of Medicine, International University of Health and Welfare (IUHW), Chiba 286-8520, Japan
3
Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Narita Hospital, Chiba 286-8520, Japan
4
Department of Orthopaedic Surgery, International University of Health and Welfare (IUHW) Mita Hospital, Tokyo 108-8329, Japan
5
Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
*
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Panagiotis Korovessis
J. Clin. Med. 2022, 11(6), 1504; https://doi.org/10.3390/jcm11061504
Received: 20 January 2022 / Revised: 7 March 2022 / Accepted: 8 March 2022 / Published: 9 March 2022
(This article belongs to the Special Issue Minimally Invasive Spinal Treatment: State of the Art)
We aimed to investigate the risk factors of spontaneous osseous fusion (SOF) of the atlantoaxial joint after closed reduction under general anesthesia followed by halo fixation (remodeling therapy) for chronic atlantoaxial rotatory fixation, and to elucidate the recovery mechanism of the rotatory range of motion (ROM) after halo removal. Twelve patients who underwent remodeling therapy were retrospectively reviewed. Five patients with SOF were categorized as the fusion group and seven patients without SOF as the non-fusion group. Three dimensional CT was used to detect direct osseous contact (DOC) of facet joints before and during halo fixation, while dynamic CT at neutral and maximally rotated head positions was performed to measure rotatory ROM after halo removal. The duration from onset to initial visit was significantly longer (3.2 vs. 5.7 months, p = 0.04), incidence of DOC during halo fixation was higher (0/7 [0%] vs. 4/5 [80%], p = 0.004), and segmental rotatory ROM of Occiput/C1 (Oc/C1) at final follow-up was larger (9.8 vs. 20.1 degrees, p = 0.003) in the fusion group. Long duration from the onset to the initial visit might induce irreversible damage to the articular surface of the affected facet, which was confirmed as DOC during halo fixation and resulted in SOF. Long duration from the onset to the initial visit and DOC during halo fixation could be used to suggest the risk for SOF. Nonetheless, rotatory ROM of Oc/C1 increased to compensate for SOF. View Full-Text
Keywords: atlantoaxial rotatory fixation (AARF); chronic AARF; remodeling therapy; facet deformity; spontaneous osseous fusion atlantoaxial rotatory fixation (AARF); chronic AARF; remodeling therapy; facet deformity; spontaneous osseous fusion
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MDPI and ACS Style

Kitamura, K.; Ishii, K.; Nagoshi, N.; Chiba, K.; Matsumoto, M.; Nakamura, M.; Watanabe, K. Spontaneous Osseous Fusion after Remodeling Therapy for Chronic Atlantoaxial Rotatory Fixation and Recovery Mechanism of Rotatory Range of Motion of the Cervical Spine. J. Clin. Med. 2022, 11, 1504. https://doi.org/10.3390/jcm11061504

AMA Style

Kitamura K, Ishii K, Nagoshi N, Chiba K, Matsumoto M, Nakamura M, Watanabe K. Spontaneous Osseous Fusion after Remodeling Therapy for Chronic Atlantoaxial Rotatory Fixation and Recovery Mechanism of Rotatory Range of Motion of the Cervical Spine. Journal of Clinical Medicine. 2022; 11(6):1504. https://doi.org/10.3390/jcm11061504

Chicago/Turabian Style

Kitamura, Kazuya, Ken Ishii, Narihito Nagoshi, Kazuhiro Chiba, Morio Matsumoto, Masaya Nakamura, and Kota Watanabe. 2022. "Spontaneous Osseous Fusion after Remodeling Therapy for Chronic Atlantoaxial Rotatory Fixation and Recovery Mechanism of Rotatory Range of Motion of the Cervical Spine" Journal of Clinical Medicine 11, no. 6: 1504. https://doi.org/10.3390/jcm11061504

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