Kinematic MRI Analysis of Reducible Atlantoaxial Dislocation for Decompression

Area of Science:

• Neurosurgery
• Orthopedic Surgery
• Radiology

Background:

• Spinal cord compression (SCC) after atlantoaxial reduction is often overlooked.
• Kinematic magnetic resonance imaging (MRI) can assess reduction and residual SCC.

Purpose of the Study:

• To analyze the role of kinematic MRI in reducible atlantoaxial dislocation.
• To guide preoperative decisions regarding spinal cord decompression.

Main Methods:

• Retrospective analysis of 36 patients with atlantoaxial reduction.
• Grouping based on preoperative kinematic MRI findings of SCC.
• Comparison of surgical decompression (C1 laminectomy) versus fixation-only.

Main Results:

• Both groups showed significant improvement in JOA scores and reduced SCC post-surgery.
• No significant difference in JOA scores or improvement rates between groups at 12 months.
• Extension MRI revealed lower SCC percentages compared to neutral MRI in all patients.

Conclusions:

• Decompression is indicated for patients with significant SCC on preoperative kinematic MRI.
• Kinematic MRI is valuable for assessing SCC and guiding surgical decisions for atlantoaxial dislocation.