Evidence map›Paper›PMID 37294357›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023

Surgical treatment of craniocervical instability: comparison of two constructs regarding clinical and radiological outcomes of 100 patients.

Mohammed Ahmed Ismail, Heinrich Boehm, Hussein Abou El Ghait, Ahmed Akar

Open access · hybridAbstract read
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In one paragraph

Article in 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, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. 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 · 2025
    Pooled it
  2. Article
  3. Article
  4. Occipitocervical surgery rescue: The "Journal of craniovertebral junction & spine
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 3 countries.

Mohammed Ahmed IsmailOrthopaedic Department, El Hussien University Hospital, Al Azhar University, Gawhar El Kaeed Street, El Darassa, Cairo, 11651, Egypt. mohammed.ismail@azhar.edu.eg.ORCID http://orcid.org/0000-0003-3476-2401
Heinrich BoehmSpine Surgery Department, Zentralklinik Bad Berka, Bad Berka, Germany.
Hussein Abou El GhaitOrthopaedic Department, El Hussien University Hospital, Al Azhar University, Gawhar El Kaeed Street, El Darassa, Cairo, 11651, Egypt.
Ahmed AkarOrthopaedic Department, El Hussien University Hospital, Al Azhar University, Gawhar El Kaeed Street, El Darassa, Cairo, 11651, Egypt.
Al-Azhar University · EGZentralklinik Bad Berka · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere is an increased demand for surgical solutions to treat craniocervical instability. This retrospective study demonstrates the clinical and radiological outcomes of unstable craniocervical junction treated with occipitocervical fusion. MATERIAL AND

methodsThe mean age of 52 females and 48 males was 56.89 years. The clinical and radiological outcomes were assessed, including NDI, VAS, ASIA score, imaging, complications and bony fusion in two used constructs: a modern occipital plate-rod-screw system (n = 59) and previous bilateral contoured titanium reconstruction plates-screws (n = 41).

resultsClinically and on imaging, patients presented with neck pain, myelopathy, radiculopathy, vascular symptoms and craniocervical instability. The mean follow-up was 6.47 years. A solid bony fusion was achieved in 93.81% of the patients. The NDI and the VAS improved significantly from 28.3 and 7.67 at the presentation to 16.2 and 3.47 at the final follow-up. The anterior and posterior atlantodental interval (AADI and PADI), the clivus canal angle (CCA), the occipitoaxial angle (OC2A) and the posterior occipitocervical angle (POCA) improved significantly. Six patients required early revision.

conclusionOccipitocervical fusion can yield excellent results regarding clinical improvement and long-term stability with a high fusion rate. Simple reconstruction plates, though more demanding surgically, achieve similar results. Preserving a neutral patient's position for fixation avoids postoperative dysphagia and may help prevent adjacent segment disease development.

Indexed as

Cervical VertebraeSpinal FusionBone PlatesBone ScrewsFemaleHumansMaleMiddle AgedRadiographyRetrospective StudiesTreatment OutcomeCraniocervical instabilityOccipitocervical fusionTransoral approachUpper cervical fixation

Identifiers

PMID37294357
OpenAlexW4379967387

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.