ArticleJournal of orthopaedic surgery and research2020
Does isolated atlantoaxial fusion result in better clinical outcome compared to occipitocervical fusion?
Article in Journal of orthopaedic surgery and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- Perioperative outcomes and technical and patient-reported success of rigid occipitocervical fusions in adults: a systematic review and meta-analysis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Atlanto-occipital dislocation: a modern case series refining management paradigms through integration of CT and MR imaging.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- A novel bone screw implantation strategy in C1-2 instability: a framework for evolving high cervical spine surgery.Neurosurgical review · 2026Article
- 3D-printed patient-specific guides improve screw accuracy in upper cervical spine surgery: a comparative study.Frontiers in neurology · 2026Article
- The Risk of Dysphagia After Short-Segment Posterior Occipital-C2 Fusion versus C1-C2 Cervical Fusion: A Retrospective Cohort Study.World neurosurgery · 2025Article
- More postoperative complications and revision surgery after occipitocervical fusion than after atlantoaxial fusion: a retrospective multicenter cohort study.Asian spine journal · 2025Article
- Higher incidence of delayed bone fusion for atlantoaxial fusion versus occipitocervical fusion with navigation system.BMC musculoskeletal disorders · 2025Article
- Risk factors and prognosis analysis of dysphagia after occipitocervical fusion surgery: a retrospective study of 43 cases.Journal of orthopaedic surgery and research · 2025Article
- Anatomical Parameters for Occipital Condyle Screws: An Analysis of 500 Condyles Using CT Scans.Global spine journal · 2022Article
- Novel Approach for Posterior C1 Double-door Laminoplasty with Atlantoaxial Fusion in Progressive Cervical Myelopathy: A Case Report.Journal of orthopaedic case reports · 2022Article
- Robot-assisted atlantoaxial fixation: illustrative cases.Journal of neurosurgery. Case lessons · 2022Article
- Occipitocervical Revision Surgery Using the Bicortical Screw and Plate System for Failed Craniovertebral Junction Stabilization.Orthopaedic surgery · 2022Article
- Complications of occipitocervical fixation: retrospective review of 128 patients with 5-year mean follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Article
- Atlantoaxial Stabilization by Posterior C1 and C2 Screw-Rod Fixation for Various Pathologies: Case Series and Comprehensive Review of Literature.Journal of neurosciences in rural practice · 2021Review
- Postoperative complication rates and hazards-model survival analysis of revision surgery following occipitocervical and atlanto-axial fusion.North American Spine Society journal · 2020Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe C0 to C2 region is the keystone for range of motion in the upper cervical spine. Posterior procedures usually include a fusion of at least one segment. Atlantoaxial fusion (AAF) only inhibits any motion in the C1/C2 segment whereas occipitocervical fusion (OCF) additionally interferes with the C0/C1 segment. The purpose of our study was to investigate clinical outcome of patients that underwent OCF or AAF for upper cervical spine injuries.
methodsOver a 5-year period (2010-2015), consecutive patients with upper cervical spine disorders were retrospectively identified as having been treated with OCF or AAF. The Numeric Pain Rating Scale (NPRS) and the Neck Disability Index (NDI) were used to evaluate postoperative neck pain and health restrictions. Demographics, follow-up, and clinical outcome parameters were evaluated. Infection, hematoma, screw malpositioning, and deaths were used as complication variables. Follow-up was at least 6 months postoperatively.
resultsNinety-six patients (male = 42, female = 54) underwent stabilization of the upper cervical spine. OCF was performed in 44 patients (45.8%), and 52 patients (54.2%) were treated with AAF. Patients with OCF were diagnosed with more comorbidities (p = 0.01). Follow-up was shorter in the OCF group compared to the AAF group (6.3 months and 14.3 months; p = 0.01). No differences were found related to infection (OCF 4.5%; AAF 7.7%) and revision rate (OCF 13.6%; AAF 17.3%; p > 0.05). Regarding bother and disability, no differences were discovered utilizing the NDI score (AAF 21.4%; OCF 37.4%; p > 0.05). A reduction of disability measured by the NDI was observed with greater follow-up for all patients (p = 0.01).
conclusionTheoretically, AAF provides greater range of motion by preserving the C0/C1 motion segment resulting in less disability. The current study did not show any significant differences regarding clinical outcome measured by the NDI compared to OCF. No differences were found regarding complication and infection rates in both groups. Both techniques provide a stable treatment with comparable clinical outcome.
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