Evidence map›Paper›PMID 39501909›Full record

ArticleOrthopaedic surgery2025

Novel MRI Signs in Atlantodental Space Predict Reduction Degree of Atlantoaxial Dislocation.

Xia-Qing Sheng, Yi-Fei Deng, Cheng-Yi Huang, Nan-Fang Pan, You-Jin Zhao, Qi-Yong Gong, Quan Gong, Yue-Ming Song, Hao Liu, Yang Meng

Abstract read
In one paragraph

Article in Orthopaedic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Xia-Qing ShengDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Yi-Fei DengDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Cheng-Yi HuangDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0001-8093-816X
Nan-Fang PanDepartment of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.
You-Jin ZhaoDepartment of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.
Qi-Yong GongDepartment of Radiology, West China Xiamen Hospital of Sichuan University, Xiamen, China.
Quan GongDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Yue-Ming SongDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Hao LiuDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0003-1748-7882
Yang MengDepartment of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China.ORCID https://orcid.org/0000-0002-8843-2240

Funding

Clinical Research Incubation Project of West China Hospital of Sichuan University 2022HXFHO33Commercialization of Scientific and Technological Achievements Funds, West China Hospital, Sichuan University CGZH19007Sichuan Province Science and Technology Support Program of China 2022YFS0101
6 · The paper itself

Abstract

objectiveThe type of atlantodental space tissue in patients with atlantoaxial dislocation (AAD) can help doctors understand the possibility of reduction before surgery. However, relevant research on this topic is lacking. This study aimed to summarize cases of AAD, classified based on the atlantodental space using magnetic resonance imaging (MRI), and preliminarily explore its impact on the degree of reduction.

methodsPreoperative T2-weighted MRIs and dynamic digital radiographs of patients who underwent posterior reduction and fixation surgery for congenital AAD between September 2012 and February 2023 were collected. The patients were classified into flexible and inflexible tissue sign groups based on T2-weighted imaging. Patients with an atlantodental interval < 3 mm on extension digital radiography were considered radiographically reducible. Three radiologists read and recorded the MRI results using standard protocols. Kappa and Fleiss kappa values were used to evaluate intra- and inter-observer agreements for MRI signs and dynamic digital radiography findings. Multivariate logistic regression and receiver operating characteristic curves were used to analyze the relationships between imaging parameters and the reduction degree.

resultsIn total, 118 patients with AAD were included in the analysis. Inter-observer agreement among the three readers was higher for MRI than for dynamic digital radiography (0.816 vs. 0.668). The intra-observer consistency for MRI signs was also better than that of dynamic digital radiography. Both the flexible tissue sign and radiographically reducible groups showed a higher rate of satisfactory reduction. However, only the flexible tissue sign showed positive results in the multivariate regression. The receiver operating characteristic curve for MRI signs as a predictor of satisfactory reduction yielded an area under the curve of 0.776 (95% confidence interval, 0.667-0.875, p < 0.0001).

conclusionsNovel MRI signs of the atlantodental space exhibited high inter- and intra-observer agreement. Patients with flexible tissue signs were more likely to achieve satisfactory reduction after direct posterior surgery.

Indexed as

Atlanto-Axial JointJoint DislocationsMagnetic Resonance ImagingAdolescentAdultChildChild, PreschoolFemaleHumansMalePredictive Value of TestsRetrospective Studiesatlantoaxial dislocationatlantodental spacecervical spinemagnetic resonance imagingreduction degree

Identifiers

PMID39501909
PMCPMC11735361

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