Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint

Shinjiro Kaneko, Ken Ishii, Kota Watanabe, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Yoshiyuki Yato, Takashi Asazuma

Research output: Contribution to journalArticle

Abstract

Purpose: Hinge-like hyper-mobility is occasionally observed at the atlanto-occipital (O-C1) joint. However, it has not been clear if this kind of hinge-like hyper-mobility at the O-C1 joint should be regarded as “pathologic”, or referred to as “instability”. To solve this issue, we aimed to establish a reliable radiographic assessment method for this specific type of O-C1 instability and figure out the “standard value” for the range of motion (ROM) of the O-C1 joint. Methods: To figure out the standard range of the O-C1 angle, we acquired magnetic resonance imaging (MRI) sagittal views of the cervical spine for 157 healthy volunteers [average: 37.4 year-old (yo)] without spine diseases, at neutral, maximum flexion and maximum extension positions. Results: The average value (AVE) for ROM of O-C1 angle was 9.91°. The standard value for ROM of O-C1 angle was calculated as 0°–21°. There was no statistically significant gender difference. We also found that the older population (≧ 40 yo) significantly had a larger ROM of O-C1 angle (AVE: 11.72°) compared to the younger population (< 40 yo) (AVE: 8.99°). Conclusions: We consider that hinge-like instability at O-C1 joint, which cannot be assessed by measuring Powers ratio, can be assessed by measuring the range of O-C1 angles using dynamic-MRI. Evaluation of O-C1 instability is important especially when we perform surgical treatment for diseases with upper cervical instability (such as retro-odontoid pseudotumor). We consider that the current study provides important information in such a case.

Original languageEnglish
Pages (from-to)1303-1308
Number of pages6
JournalEuropean Spine Journal
Volume27
Issue number6
DOIs
Publication statusPublished - 01-06-2018

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Atlanto-Occipital Joint
Articular Range of Motion
Joints
Spine
Magnetic Resonance Imaging
Population
Healthy Volunteers

All Science Journal Classification (ASJC) codes

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Kaneko, Shinjiro ; Ishii, Ken ; Watanabe, Kota ; Tsuji, Takashi ; Nakamura, Masaya ; Matsumoto, Morio ; Yato, Yoshiyuki ; Asazuma, Takashi. / Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint. In: European Spine Journal. 2018 ; Vol. 27, No. 6. pp. 1303-1308.
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abstract = "Purpose: Hinge-like hyper-mobility is occasionally observed at the atlanto-occipital (O-C1) joint. However, it has not been clear if this kind of hinge-like hyper-mobility at the O-C1 joint should be regarded as “pathologic”, or referred to as “instability”. To solve this issue, we aimed to establish a reliable radiographic assessment method for this specific type of O-C1 instability and figure out the “standard value” for the range of motion (ROM) of the O-C1 joint. Methods: To figure out the standard range of the O-C1 angle, we acquired magnetic resonance imaging (MRI) sagittal views of the cervical spine for 157 healthy volunteers [average: 37.4 year-old (yo)] without spine diseases, at neutral, maximum flexion and maximum extension positions. Results: The average value (AVE) for ROM of O-C1 angle was 9.91°. The standard value for ROM of O-C1 angle was calculated as 0°–21°. There was no statistically significant gender difference. We also found that the older population (≧ 40 yo) significantly had a larger ROM of O-C1 angle (AVE: 11.72°) compared to the younger population (< 40 yo) (AVE: 8.99°). Conclusions: We consider that hinge-like instability at O-C1 joint, which cannot be assessed by measuring Powers ratio, can be assessed by measuring the range of O-C1 angles using dynamic-MRI. Evaluation of O-C1 instability is important especially when we perform surgical treatment for diseases with upper cervical instability (such as retro-odontoid pseudotumor). We consider that the current study provides important information in such a case.",
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Kaneko, S, Ishii, K, Watanabe, K, Tsuji, T, Nakamura, M, Matsumoto, M, Yato, Y & Asazuma, T 2018, 'Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint', European Spine Journal, vol. 27, no. 6, pp. 1303-1308. https://doi.org/10.1007/s00586-017-5349-3

Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint. / Kaneko, Shinjiro; Ishii, Ken; Watanabe, Kota; Tsuji, Takashi; Nakamura, Masaya; Matsumoto, Morio; Yato, Yoshiyuki; Asazuma, Takashi.

In: European Spine Journal, Vol. 27, No. 6, 01.06.2018, p. 1303-1308.

Research output: Contribution to journalArticle

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T1 - Exploration for reliable radiographic assessment method for hinge-like hypermobility at atlanto-occipital joint

AU - Kaneko, Shinjiro

AU - Ishii, Ken

AU - Watanabe, Kota

AU - Tsuji, Takashi

AU - Nakamura, Masaya

AU - Matsumoto, Morio

AU - Yato, Yoshiyuki

AU - Asazuma, Takashi

PY - 2018/6/1

Y1 - 2018/6/1

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