Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up
Abstract Objective To investigate the necessity of nonstructural or structural intraarticular bone grafting in atlantoaxial facet joints via a posterior approach and the influence by the presence of basilar invagination (BI). Methods From November 2016 to October 2018, patients who underwent posteri...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-021-02630-z |
| _version_ | 1798042687704662016 |
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| author | Jun Zhu Jian Wu Keyu Luo Zhong Wang Huaijian Jin Yufei Jin Yingbo Wang Mingyong Liu Peng Liu |
| author_facet | Jun Zhu Jian Wu Keyu Luo Zhong Wang Huaijian Jin Yufei Jin Yingbo Wang Mingyong Liu Peng Liu |
| author_sort | Jun Zhu |
| collection | DOAJ |
| description | Abstract Objective To investigate the necessity of nonstructural or structural intraarticular bone grafting in atlantoaxial facet joints via a posterior approach and the influence by the presence of basilar invagination (BI). Methods From November 2016 to October 2018, patients who underwent posterior atlantoaxial or occipitocervical arthrodesis surgery at one institute were retrospectively reviewed. Operation records, preoperative and postoperative clinical status, and radiological films were analyzed. Results Thirty-three patients (19 without BI, 14 with BI) underwent posterior facet joint release followed by intraarticular bone grafting were enrolled finally. Twenty-four nonstructural (15 without BI, 9 with BI) and 9 structural (4 without BI, 5 with BI) grafting were performed. The average follow-up was 32.15±6.73 months (24–47 months). Among them, 1 (3.03%) implant failure occurred, and 32 (96.97%) achieved satisfactory neurological outcomes, including 28 (84.85%) complete and 4 (12.12%) acceptable reductions with complete fusion within 6 months. For patients without BI, structural and nonstructural grafting showed no significant difference in terms of reduction maintenance (100% vs 73.33%, p = 0.530), while for those with BI, structural grafting significantly increased the postoperative height of the joint space (5.67±1.22 mm vs 3.43±1.78 mm, p = 0.002) and maintained it much better than nonstructural grafting (88.89% vs 20.00%, p = 0.023), contributing notably to BI correction. Conclusion Intraarticular structural bone grafting in atlantoaxial facet joints has the advantage of maintaining anterior column height in the case of lateral mass collapse or when BI correction is needed; otherwise, nonstructural bone grafting is enough. |
| first_indexed | 2024-04-11T22:38:56Z |
| format | Article |
| id | doaj.art-c3060fdc7fc34f2ab81d843e26d2aed0 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T22:38:56Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-c3060fdc7fc34f2ab81d843e26d2aed02022-12-22T03:59:07ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-08-011611910.1186/s13018-021-02630-zIntraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-upJun Zhu0Jian Wu1Keyu Luo2Zhong Wang3Huaijian Jin4Yufei Jin5Yingbo Wang6Mingyong Liu7Peng Liu8Division of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityDivision of Spine Surgery, Department of Orthopedics, Daping Hospital of Army Medical UniversityAbstract Objective To investigate the necessity of nonstructural or structural intraarticular bone grafting in atlantoaxial facet joints via a posterior approach and the influence by the presence of basilar invagination (BI). Methods From November 2016 to October 2018, patients who underwent posterior atlantoaxial or occipitocervical arthrodesis surgery at one institute were retrospectively reviewed. Operation records, preoperative and postoperative clinical status, and radiological films were analyzed. Results Thirty-three patients (19 without BI, 14 with BI) underwent posterior facet joint release followed by intraarticular bone grafting were enrolled finally. Twenty-four nonstructural (15 without BI, 9 with BI) and 9 structural (4 without BI, 5 with BI) grafting were performed. The average follow-up was 32.15±6.73 months (24–47 months). Among them, 1 (3.03%) implant failure occurred, and 32 (96.97%) achieved satisfactory neurological outcomes, including 28 (84.85%) complete and 4 (12.12%) acceptable reductions with complete fusion within 6 months. For patients without BI, structural and nonstructural grafting showed no significant difference in terms of reduction maintenance (100% vs 73.33%, p = 0.530), while for those with BI, structural grafting significantly increased the postoperative height of the joint space (5.67±1.22 mm vs 3.43±1.78 mm, p = 0.002) and maintained it much better than nonstructural grafting (88.89% vs 20.00%, p = 0.023), contributing notably to BI correction. Conclusion Intraarticular structural bone grafting in atlantoaxial facet joints has the advantage of maintaining anterior column height in the case of lateral mass collapse or when BI correction is needed; otherwise, nonstructural bone grafting is enough.https://doi.org/10.1186/s13018-021-02630-zBone graftingFusionAtlantoaxial complexFacet jointReduction |
| spellingShingle | Jun Zhu Jian Wu Keyu Luo Zhong Wang Huaijian Jin Yufei Jin Yingbo Wang Mingyong Liu Peng Liu Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up Journal of Orthopaedic Surgery and Research Bone grafting Fusion Atlantoaxial complex Facet joint Reduction |
| title | Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up |
| title_full | Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up |
| title_fullStr | Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up |
| title_full_unstemmed | Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up |
| title_short | Intraarticular bone grafting in atlantoaxial facet joints via a posterior approach: nonstructural or structural—a minimum 24-month follow-up |
| title_sort | intraarticular bone grafting in atlantoaxial facet joints via a posterior approach nonstructural or structural a minimum 24 month follow up |
| topic | Bone grafting Fusion Atlantoaxial complex Facet joint Reduction |
| url | https://doi.org/10.1186/s13018-021-02630-z |
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