Evidence map›Paper›PMID 40021538›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 Society2025

Radiological features and internal fixation strategies of atlantoaxial dislocation combined with atlas occipitalization.

Jiang Liu, Li Jia, Minghui Zeng, Hao Xu, Shuli Zhao, Rui Zhang, Qi Pang

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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, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. In vivo three-dimensional kinematics of the upper cervical spine during upright head rotation in patients with atlantoaxial dislocation.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 · 2026
    Article
  2. Three-dimensional quantitative CT analysis of the C2 spinous process and its implications for spinous process screw fixation.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 · 2026
    Article
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4 · The record

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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

7 authors.

Jiang LiuDepartment of Neurosurgery, Shandong Provincial Hospital, Shandong University, Ji'nan, Shandong, 250021, China.
Li JiaDepartment of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Minghui ZengDepartment of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Hao XuDepartment of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Shuli ZhaoDepartment of Radiology, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Rui ZhangDepartment of Neurosurgery, Shandong Provincial Hospital, Shandong University, Ji'nan, Shandong, 250021, China.
Qi PangDepartment of Neurosurgery, Shandong Provincial Hospital, Shandong University, Ji'nan, Shandong, 250021, China. sjjzwklj@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPatients with atlantoaxial dislocation combined with atlas occipitalization often present with variations in the anatomy of the vertebral artery and bone, posing potential risks during the implantation of the C2 pedicle screws during surgery.

objectiveBased on comprehensive preoperative imaging evaluation, this study investigates the blood supply, course, and relationship with bone of the vertebral artery in patients with atlantoaxial dislocation combined with atlas occipitalization, aiming to provide reference for safe implantation of internal fixation.

methodsImaging data of 77 patients with atlantoaxial dislocation combined with atlas occipitalization from October 2015 to December 2023 at the First Affiliated Hospital of the University of Science and Technology of China were collected, including CT, CT angiography, and MRI. The blood supply, course, and relationship with surrounding structure of the vertebral artery were analyzed using PACS and RadiAnt software.

resultsThere were 18 males and 59 females, with an average age of 48.5 ± 10.5 years (range: 17-71 years). Forty-one cases (53.2%) were associated with congenital C2-3 fusion(Klippel-Feil syndrome). Vertebral artery blood supply was predominantly unilateral (including single blood supply) in 56 cases (72.7%), with left-sided predominance (62.5%). Segment V3 course variations of the vertebral artery were common, with 47 cases (35.6%) not entering the transverse foramen of C1. High-riding vertebral arteries were present in 36 cases (46.8%), with 22 cases (61.1%) associated with congenital C2-3 fusion. The average width of the axis pedicle on the high-riding side was 2.13 ± 1.2 mm, and the height of the isthmus was ≤ 5 mm, with an average of 2.55 ± 1.07 mm. There was a loose gap on the lateral side of the vertebral artery within the transverse foramen, with an average of 2.1 mm, and the corresponding width of the subarachnoid space on the inner side of the axis pedicle was 3.48 mm.

conclusionComprehensive preoperative imaging evaluation can reduce the risk of vertebral artery injury during surgery in patients with congenital atlantoaxial dislocation combined with atlas occipitalization, and provide feasible and optimized internal fixation solutions.

Indexed as

Atlanto-Axial JointCervical AtlasJoint DislocationsSpinal FusionVertebral ArteryAdolescentAdultAgedFemaleHumansKlippel-Feil SyndromeMagnetic Resonance ImagingMaleMiddle AgedYoung AdultAtlanto-axial jointAtlas occipitalizationCT angiographyDislocationHigh-riding vertebral arteryPedicle screw

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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.