A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis
Introduction: The objective of this study is to propose a novel classification and algorithmic-based management plan for craniovertebral junction osteoarthrosis (CVJOA). Materials and Methods: A retrospective study was done based on prospective database of radiological studies and clinical history....
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2020-01-01
|
| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2020;volume=11;issue=4;spage=321;epage=330;aulast=Texeira |
| _version_ | 1828941814357295104 |
|---|---|
| author | Luis Eduardo Carelli Texeira da Silva Ahsan Ali Khan Alderico Girão Campos de Barros Fernando Miguel Krywinski Fabio Antonio Cabral de Araujo Fagundes Felipe Gomes de Souza e Silva |
| author_facet | Luis Eduardo Carelli Texeira da Silva Ahsan Ali Khan Alderico Girão Campos de Barros Fernando Miguel Krywinski Fabio Antonio Cabral de Araujo Fagundes Felipe Gomes de Souza e Silva |
| author_sort | Luis Eduardo Carelli Texeira da Silva |
| collection | DOAJ |
| description | Introduction: The objective of this study is to propose a novel classification and algorithmic-based management plan for craniovertebral junction osteoarthrosis (CVJOA).
Materials and Methods: A retrospective study was done based on prospective database of radiological studies and clinical history. Twenty symptomatic patients (12 females and 8 males) with a mean age of 54.8 years were identified with CVJOA. These patients underwent either nonsurgical treatment only or surgical intervention and had follow-up of at least 14 months. Classification of CVJOA is based on coronal deformity, rigidity, stability, and two modifiers. The main surgical procedures done in the surgical arm of these patients included C1–C2 fusion, C1–C2 facet distraction and fusion, and unilateral subaxial facet distraction, and posterior column osteotomy.
Results: All the twenty patients included in this study complained of either sub-occipital or upper neck pain and had radiological evidence of CVJOA. Seven patients improved with nonsurgical management and 13 underwent surgical intervention. Surgical recommendations for each type of CVJOA have been described with case examples, and algorithm for the management of CVJOA has been developed based on this study. Interobserver agreement on CVJOA classification was measured using kappa value statistics which showed moderate strength of agreement (0.467).
Conclusion: This study describes a novel classification and management of CVJOA based on algorithm and current surgical recommendations for each type of CVJOA. |
| first_indexed | 2024-12-14T03:43:15Z |
| format | Article |
| id | doaj.art-ab143306481d4f3fb2fcd4ac0c7022a7 |
| institution | Directory Open Access Journal |
| issn | 0974-8237 |
| language | English |
| last_indexed | 2024-12-14T03:43:15Z |
| publishDate | 2020-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj.art-ab143306481d4f3fb2fcd4ac0c7022a72022-12-21T23:18:26ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82372020-01-0111432133010.4103/jcvjs.JCVJS_172_20A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosisLuis Eduardo Carelli Texeira da SilvaAhsan Ali KhanAlderico Girão Campos de BarrosFernando Miguel KrywinskiFabio Antonio Cabral de Araujo FagundesFelipe Gomes de Souza e SilvaIntroduction: The objective of this study is to propose a novel classification and algorithmic-based management plan for craniovertebral junction osteoarthrosis (CVJOA). Materials and Methods: A retrospective study was done based on prospective database of radiological studies and clinical history. Twenty symptomatic patients (12 females and 8 males) with a mean age of 54.8 years were identified with CVJOA. These patients underwent either nonsurgical treatment only or surgical intervention and had follow-up of at least 14 months. Classification of CVJOA is based on coronal deformity, rigidity, stability, and two modifiers. The main surgical procedures done in the surgical arm of these patients included C1–C2 fusion, C1–C2 facet distraction and fusion, and unilateral subaxial facet distraction, and posterior column osteotomy. Results: All the twenty patients included in this study complained of either sub-occipital or upper neck pain and had radiological evidence of CVJOA. Seven patients improved with nonsurgical management and 13 underwent surgical intervention. Surgical recommendations for each type of CVJOA have been described with case examples, and algorithm for the management of CVJOA has been developed based on this study. Interobserver agreement on CVJOA classification was measured using kappa value statistics which showed moderate strength of agreement (0.467). Conclusion: This study describes a novel classification and management of CVJOA based on algorithm and current surgical recommendations for each type of CVJOA.http://www.jcvjs.com/article.asp?issn=0974-8237;year=2020;volume=11;issue=4;spage=321;epage=330;aulast=Texeirac1-c2 fusioncervical paincraniovertebral junctionfacet distractionosteoarthrosis |
| spellingShingle | Luis Eduardo Carelli Texeira da Silva Ahsan Ali Khan Alderico Girão Campos de Barros Fernando Miguel Krywinski Fabio Antonio Cabral de Araujo Fagundes Felipe Gomes de Souza e Silva A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis Journal of Craniovertebral Junction and Spine c1-c2 fusion cervical pain craniovertebral junction facet distraction osteoarthrosis |
| title | A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis |
| title_full | A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis |
| title_fullStr | A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis |
| title_full_unstemmed | A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis |
| title_short | A novel classification and algorithmic-based management of craniovertebral junction osteoarthrosis |
| title_sort | novel classification and algorithmic based management of craniovertebral junction osteoarthrosis |
| topic | c1-c2 fusion cervical pain craniovertebral junction facet distraction osteoarthrosis |
| url | http://www.jcvjs.com/article.asp?issn=0974-8237;year=2020;volume=11;issue=4;spage=321;epage=330;aulast=Texeira |
| work_keys_str_mv | AT luiseduardocarellitexeiradasilva anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT ahsanalikhan anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT aldericogiraocamposdebarros anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT fernandomiguelkrywinski anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT fabioantoniocabraldearaujofagundes anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT felipegomesdesouzaesilva anovelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT luiseduardocarellitexeiradasilva novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT ahsanalikhan novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT aldericogiraocamposdebarros novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT fernandomiguelkrywinski novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT fabioantoniocabraldearaujofagundes novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis AT felipegomesdesouzaesilva novelclassificationandalgorithmicbasedmanagementofcraniovertebraljunctionosteoarthrosis |