CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS

CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS

ABSTRACT Introduction/Objective: The craniovertebral junction (CVJ) requires a detailed evaluation, as the changes in alignment caused by surgery can affect adjacent structures in a secondary way. Examples of these effects are dyspnea or dysphagia after posterior occipitocervical arthrodesis, due to decreased caliber of the oropharynx. These changes can be identified perioperatively by several radiographic parameters that aim to predict possible postoperative respiratory complications. Such complications appear to be related to the narrowest oropharyngeal airway space (nPAS), and may also occur following atlantoaxial (C1-C2) arthrodesis. This work aims to correlate the variation in CVJ alignment parameters before and after C1-C2 arthrodesis with the variation in nPAS. Methods: Patients who underwent posterior C1-C2 arthrodesis between 2011 and 2019 at the National Institute of Traumatology and Orthopedics (INTO) were included in the study, totaling 26 patients. The parameters evaluated included cervical lordosis, C1-C2 angle, slope of C2, Occipito-C2 angle (O-C2), pharyngeal inlet angle (PIA), pharyngeal tilt angle (PTA), occiput and external acoustic meatus to axis angle (O-EAa), cranial transverse motion against C2 angle (C2TA), axial tilt (AT) and the percentage of change in nPAS (%∆nPAS). Results: A correlation was observed between the change in C1-C2 angle, O-C2, PTA, C2TA and the %∆nPAS. Conclusion: The change in cervical alignment and CVJ parameters is correlated with %∆nPAS and should, therefore, be evaluated before and after atlantoaxial fusion as a means of predicting a possible respiratory complication. Level of Evidence: III; Cross sectional study .

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Main Authors: Silva,Luis Eduardo Carelli Teixeira da, Barros,Alderico Girão Campos de, Fagundes,Fábio Antônio Cabral de Araújo, Atencio,Gamaliel Gonzalez
Format: Digital revista
Language:English
Published: Sociedade Brasileira de Coluna 2022
Online Access:http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512022000100201
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spelling oai:scielo:S1808-185120220001002012022-03-31CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESISSilva,Luis Eduardo Carelli Teixeira daBarros,Alderico Girão Campos deFagundes,Fábio Antônio Cabral de AraújoAtencio,Gamaliel Gonzalez Dyspnea Deglutition Disorders Arthrodesis Atlanto -Axial Joint Cervical Vertebral ABSTRACT Introduction/Objective: The craniovertebral junction (CVJ) requires a detailed evaluation, as the changes in alignment caused by surgery can affect adjacent structures in a secondary way. Examples of these effects are dyspnea or dysphagia after posterior occipitocervical arthrodesis, due to decreased caliber of the oropharynx. These changes can be identified perioperatively by several radiographic parameters that aim to predict possible postoperative respiratory complications. Such complications appear to be related to the narrowest oropharyngeal airway space (nPAS), and may also occur following atlantoaxial (C1-C2) arthrodesis. This work aims to correlate the variation in CVJ alignment parameters before and after C1-C2 arthrodesis with the variation in nPAS. Methods: Patients who underwent posterior C1-C2 arthrodesis between 2011 and 2019 at the National Institute of Traumatology and Orthopedics (INTO) were included in the study, totaling 26 patients. The parameters evaluated included cervical lordosis, C1-C2 angle, slope of C2, Occipito-C2 angle (O-C2), pharyngeal inlet angle (PIA), pharyngeal tilt angle (PTA), occiput and external acoustic meatus to axis angle (O-EAa), cranial transverse motion against C2 angle (C2TA), axial tilt (AT) and the percentage of change in nPAS (%∆nPAS). Results: A correlation was observed between the change in C1-C2 angle, O-C2, PTA, C2TA and the %∆nPAS. Conclusion: The change in cervical alignment and CVJ parameters is correlated with %∆nPAS and should, therefore, be evaluated before and after atlantoaxial fusion as a means of predicting a possible respiratory complication. Level of Evidence: III; Cross sectional study .info:eu-repo/semantics/openAccessSociedade Brasileira de ColunaColuna/Columna v.21 n.1 20222022-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512022000100201en10.1590/s1808-185120222101250508
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language English
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author Silva,Luis Eduardo Carelli Teixeira da
Barros,Alderico Girão Campos de
Fagundes,Fábio Antônio Cabral de Araújo
Atencio,Gamaliel Gonzalez
spellingShingle Silva,Luis Eduardo Carelli Teixeira da
Barros,Alderico Girão Campos de
Fagundes,Fábio Antônio Cabral de Araújo
Atencio,Gamaliel Gonzalez
CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
author_facet Silva,Luis Eduardo Carelli Teixeira da
Barros,Alderico Girão Campos de
Fagundes,Fábio Antônio Cabral de Araújo
Atencio,Gamaliel Gonzalez
author_sort Silva,Luis Eduardo Carelli Teixeira da
title CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
title_short CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
title_full CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
title_fullStr CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
title_full_unstemmed CORRELATION OF craniovertebral PARAMETERS WITH THE RETROPHARYNGEAL SPACE IN POSTERIOR C1-C2 ARTHRODESIS
title_sort correlation of craniovertebral parameters with the retropharyngeal space in posterior c1-c2 arthrodesis
description ABSTRACT Introduction/Objective: The craniovertebral junction (CVJ) requires a detailed evaluation, as the changes in alignment caused by surgery can affect adjacent structures in a secondary way. Examples of these effects are dyspnea or dysphagia after posterior occipitocervical arthrodesis, due to decreased caliber of the oropharynx. These changes can be identified perioperatively by several radiographic parameters that aim to predict possible postoperative respiratory complications. Such complications appear to be related to the narrowest oropharyngeal airway space (nPAS), and may also occur following atlantoaxial (C1-C2) arthrodesis. This work aims to correlate the variation in CVJ alignment parameters before and after C1-C2 arthrodesis with the variation in nPAS. Methods: Patients who underwent posterior C1-C2 arthrodesis between 2011 and 2019 at the National Institute of Traumatology and Orthopedics (INTO) were included in the study, totaling 26 patients. The parameters evaluated included cervical lordosis, C1-C2 angle, slope of C2, Occipito-C2 angle (O-C2), pharyngeal inlet angle (PIA), pharyngeal tilt angle (PTA), occiput and external acoustic meatus to axis angle (O-EAa), cranial transverse motion against C2 angle (C2TA), axial tilt (AT) and the percentage of change in nPAS (%∆nPAS). Results: A correlation was observed between the change in C1-C2 angle, O-C2, PTA, C2TA and the %∆nPAS. Conclusion: The change in cervical alignment and CVJ parameters is correlated with %∆nPAS and should, therefore, be evaluated before and after atlantoaxial fusion as a means of predicting a possible respiratory complication. Level of Evidence: III; Cross sectional study .
publisher Sociedade Brasileira de Coluna
publishDate 2022
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1808-18512022000100201
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