Clinical Trial: Posterior Compression Distraction Reduction (CDR)Technique in the Treatment of BI-AAD
Study Status: Recruiting
Recruit Status: Recruiting
Study Type: Interventional
Official Title: Posterior Compression - Distraction Reduction (CDR) Technique in the Treatment of Basilar Invagination Associated With Atlantoaxial Dislocation
Brief Summary: Posterior compression - distraction reduction technique (CDR) in the treatment of Basilar invagination associated with atlantoaxial dislocation
Detailed Summary:
Basilar invagination (BI) refers to the skull base into the direction of cervical spine, mainly to the odontoid process into the foramen magnum is a major change of congenital cranial vertebral junction malformation. Different from trauma or inflammatory lesions, there exists not only in horizontal but also vertical direction dislocation between atlas and axis,At present there is no satisfactory and widely accepted operation method. At present, the main treatment strategy is adopt skull traction to patients preoperative or intraoperative and make vertebra X-ray observation. If the skull traction restored the atlanto-axial dislocation, This case belongs to restorable atlanto-axial dislocation. If the skull traction cannot restore the dislocation, that is non-restorable atlanto-axial dislocation. For the restorable type, posterior occipital cervical internal fixation and fusion should be performed. For the non restorable cases, the main theories is that various ligaments and scars is formed between the anterior arch of atlas and the odontoid process lead to the causes of the longitudinal traction, so transoral anterior atlanto-axial joint lysis is needed first, and then adopt posterior occipital-cervical internal fixation and interbody fusion after the atlanto-axial dislocation is restored. Because the anterior trans-oral atlanto-axial joint lysis has weakness of difficult and high risk, it has limit the popularization of the treatment of atlanto-axial dislocation. Currently only a few several spinal surgery centers have the ability to carry out. Another problem of this treatment strategy is that the function of posterior operation confined to occipital-cervical fixation in situ but not considered the try to adopt the posterior open reduction, this is mainly due to the current clinical application of occipital cervical posterior fixation system be lack of the pressure reduction effect.
Original Primary Outcome: Same as current
Current Secondary Outcome: The second follow-up after operation Record the patients' cervical JOA score, ASIA score [ Time Frame: 6 months post operation ]
Original Secondary Outcome: Same as current
Information By: Xuanwu Hospital, Beijing
Dates:
Date Received: June 1, 2015
Date Started: July 2014
Date Completion: June 2017
Last Updated: June 1, 2015
Last Verified: January 2015