論文

査読有り
2014年12月

Novel 2 Radiographical Measurements for Atlantoaxial Instability in Children With Down Syndrome

SPINE
  • Naoyuki Nakamura
  • ,
  • Yutaka Inaba
  • ,
  • Masatoshi Oba
  • ,
  • Yoichi Aota
  • ,
  • Yogen Morikawa
  • ,
  • Yurika Ata
  • ,
  • Jiro Machida
  • ,
  • Tomoyuki Saito

39
26
開始ページ
E1566
終了ページ
E1574
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1097/BRS.0000000000000625
出版者・発行元
LIPPINCOTT WILLIAMS & WILKINS

Study Design. A retrospective case-control study.
Objective. To assess the usefulness and reproducibility of 2 novel safe and simple radiographical measurements for atlantoaxial instability in children with Down syndrome.
Summary of Background Data. In pediatric atlantoaxial instability, early diagnosis is important for improved outcomes because of poor postoperative recovery in progressed neurological symptoms. Conventional dynamic radiography of the cervical spine is associated with a potential risk of worsening neurological symptoms.
Methods. We retrospectively reviewed the medical records of 50 patients (24 boys and 26 girls) with atlantoaxial instability associated with Down syndrome. Of the 50 children, 11 had undergone and 4 had been scheduled for surgery (surgical group). In this investigation, in addition to the atlas-dens interval (ADI) and space available for spinal cord (SAC), we measured C1 inclination angle and C1/4 SAC ratio on lateral radiographs of the cervical spine in the neutral position. To assess the diagnostic abilities of these indices to determine indication for surgery, receiver operating characteristic analysis of each index was performed, and their diagnostic abilities were compared using the area under the receiver operating characteristic curve. Moreover, we assessed reproducibility of our 2 proposed indices.
Results. The discriminatory abilities of C1/4 SAC ratio (area under the receiver operating characteristic curve, 1.00)and C1 inclination angle (0.91) were comparable with those of ADI (0.98) and SAC (0.95). For the interobserver and intraobserver reliability of the novel indices, the correlation coefficients were in the range from 0.88 to 0.99. Correlation was observed between the ADI and C1/4 SAC ratio (r = 0.507, P < 0.01) and between the ADI and C1 inclination angle (r = 0.407, P < 0.01).
Conclusion. The diagnostic abilities of the 2 novel radiographical measurements were comparable with those of ADI and SAC. Moreover, these novel measurements can be obtained safely on lateral radiographs of the cervical spine in the neutral position.

Web of Science ® 被引用回数 : 2

リンク情報
DOI
https://doi.org/10.1097/BRS.0000000000000625
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/25271511
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000346480500003&DestApp=WOS_CPL

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