A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria
Objective Joint manipulation for craniovertebral junction instability is often hindered by the C2-ganglion (C2G). Our study aims to compare the surgical outcome among patients with or without C2G preservation and discuss the technical nuances. Methods We did a prospective, bicentric study and includ...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Spinal Neurosurgery Society
2021-03-01
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| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://www.e-neurospine.org/upload/pdf/ns-2040238-119.pdf |
| _version_ | 1797331682122006528 |
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| author | Suyash Singh Arun Kumar Srivastava Jayesh Sardhara Kamlesh Singh Bhaisora Kuntal Kanti Das Anant Mehrotra Awadhesh Kumar Jaiswal Manas Kumar Panigrahi Sanjay Behari |
| author_facet | Suyash Singh Arun Kumar Srivastava Jayesh Sardhara Kamlesh Singh Bhaisora Kuntal Kanti Das Anant Mehrotra Awadhesh Kumar Jaiswal Manas Kumar Panigrahi Sanjay Behari |
| author_sort | Suyash Singh |
| collection | DOAJ |
| description | Objective Joint manipulation for craniovertebral junction instability is often hindered by the C2-ganglion (C2G). Our study aims to compare the surgical outcome among patients with or without C2G preservation and discuss the technical nuances. Methods We did a prospective, bicentric study and included all the operated patients with craniovertebral junction anomaly. The outcome was assessed by the Pain Numeric Rating Scale, Patient Satisfactions Score, and Stony Brook Scar Evaluation Scale. The fusion was assessed using Lenke fusion grade. Results One hundred seventy-one patients (88 in group A and 83 in group B) were included. The most common symptom was spastic quadriparesis (n = 165, 96.5%) with median Nurick grade 3.3. Thirteen patients had suboccipital numbness and 12 patients had paraesthesia. Mean blood loss in group A was 490 ± 96.2 mL and group B was 525 ± 45.7 mL; median operative time was 217.9 and 162.2 minutes in the groups A and B, respectively (p < 0.05). At the follow-up (median, 46.8 months), Lenke fusion grade A was achieved in 92.4% and grade B in 7.6%. A trend suggesting better functional outcomes (numbness, parestheisa, scar outcome, and postoperative ulcer formation) in group A was seen with all 6 patients, who underwent O-C2 fixation, developed pressure sore. Conclusion Our results support ganglion preservation, especially in the subset of patients where occipital plating is required. Although the study fails to show any statistical significance, we suggest that one should always start with an ‘intent’ of preservation as the functional outcome is better. |
| first_indexed | 2024-03-08T07:38:59Z |
| format | Article |
| id | doaj.art-4eac5bcdc3cf43ecbee90678a11436f6 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:38:59Z |
| publishDate | 2021-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-4eac5bcdc3cf43ecbee90678a11436f62024-02-02T17:54:18ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912021-03-01181879510.14245/ns.2040238.1191075A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s CriteriaSuyash Singh0Arun Kumar Srivastava1Jayesh Sardhara2Kamlesh Singh Bhaisora3Kuntal Kanti Das4Anant Mehrotra5Awadhesh Kumar Jaiswal6Manas Kumar Panigrahi7Sanjay Behari8 All India Institute of Medical Sciences, Raebareli, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India Department of Neurosurgery, K.I.M.S. Hospital, Hyderabad, India Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IndiaObjective Joint manipulation for craniovertebral junction instability is often hindered by the C2-ganglion (C2G). Our study aims to compare the surgical outcome among patients with or without C2G preservation and discuss the technical nuances. Methods We did a prospective, bicentric study and included all the operated patients with craniovertebral junction anomaly. The outcome was assessed by the Pain Numeric Rating Scale, Patient Satisfactions Score, and Stony Brook Scar Evaluation Scale. The fusion was assessed using Lenke fusion grade. Results One hundred seventy-one patients (88 in group A and 83 in group B) were included. The most common symptom was spastic quadriparesis (n = 165, 96.5%) with median Nurick grade 3.3. Thirteen patients had suboccipital numbness and 12 patients had paraesthesia. Mean blood loss in group A was 490 ± 96.2 mL and group B was 525 ± 45.7 mL; median operative time was 217.9 and 162.2 minutes in the groups A and B, respectively (p < 0.05). At the follow-up (median, 46.8 months), Lenke fusion grade A was achieved in 92.4% and grade B in 7.6%. A trend suggesting better functional outcomes (numbness, parestheisa, scar outcome, and postoperative ulcer formation) in group A was seen with all 6 patients, who underwent O-C2 fixation, developed pressure sore. Conclusion Our results support ganglion preservation, especially in the subset of patients where occipital plating is required. Although the study fails to show any statistical significance, we suggest that one should always start with an ‘intent’ of preservation as the functional outcome is better.http://www.e-neurospine.org/upload/pdf/ns-2040238-119.pdfc2-ganglioncraniovertebral junctionjoint manipulationpatient satisfaction scorepressure sore |
| spellingShingle | Suyash Singh Arun Kumar Srivastava Jayesh Sardhara Kamlesh Singh Bhaisora Kuntal Kanti Das Anant Mehrotra Awadhesh Kumar Jaiswal Manas Kumar Panigrahi Sanjay Behari A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria Neurospine c2-ganglion craniovertebral junction joint manipulation patient satisfaction score pressure sore |
| title | A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria |
| title_full | A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria |
| title_fullStr | A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria |
| title_full_unstemmed | A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria |
| title_short | A Prospective, Single-Blinded, Bicentric Study, and Literature Review to Assess the Need of C2-Ganglion Preservation - SAVIOUR’s Criteria |
| title_sort | prospective single blinded bicentric study and literature review to assess the need of c2 ganglion preservation saviour s criteria |
| topic | c2-ganglion craniovertebral junction joint manipulation patient satisfaction score pressure sore |
| url | http://www.e-neurospine.org/upload/pdf/ns-2040238-119.pdf |
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