Genetically predicted C-reactive protein mediates the association between rheumatoid arthritis and atlantoaxial subluxation.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 2. Spine (Phila Pa 1976). 2017 Dec 1;42(23):1763-1771. doi: 10.1097/BRS.0000000000002222. Postoperative Regression of Retro-odontoid Pseudotumor After Atlantoaxial Posterior Fixation: 11 Years of Experience in Patients With Atlantoaxial Instability. Park JH(1), Lee E(1), Lee JW(1), Kang Y(1), Ahn JM(1), Yeom JS(2), Kang HS(1). Author information: (1)Department of Radiology, Seoul National University Bundang Hospital, Seong Nam, Gyeongi-do, Republic of Korea. (2)Orthopedic Surgery, Seoul National University Bundang Hospital, Seong Nam, Gyeongi-do, Republic of Korea. STUDY DESIGN: Case series study. OBJECTIVE: The aim was to investigate the incidence of retro-odontoid pseudotumor in patients with atlantoaxial instability (AAI) and evaluate pseudotumor regression after posterior fixation. SUMMARY OF BACKGROUND DATA: The incidence of retro-odontoid pseudotumor in atlantoaxial instability patients remains uncertain. Moreover, the regression of retro-odontoid pseudotumor after posterior fixation in patients with various underlying diseases needs to be further investigated. METHODS: From July 2004 to August 2015, 175 patients with AAI underwent posterior fixation operations at our institution. After excluding 11 patients (previous operation, n = 4; history of tumor, n = 7), the final study population comprised 164 patients. The final study population was categorized according to their underlying diseases (rheumatoid arthritis [RA], os odontoideum, atlanto-occipital assimilation, dens fracture, AAI of unknown cause, etc.) and age (adult and pediatric groups). The incidence of retro-odontoid pseudotumor in each group was analyzed. Pre- and postoperative magnetic resonance or computed tomography images were reviewed to assess its regression following surgery. RESULTS: Of the 164 patients included, 38 had retro-odontoid pseudotumor (23.2%). Three were diagnosed with RA and the rest were non-RA patients including os odontoideum (n = 12), dens fracture (n = 6), atlanto-occipital assimilation (n = 4), Morquio syndrome (n = 1), and AAI of unknown cause (n = 12). Pseudotumor size regressed in all 38 patients after atlantoaxial posterior fixation. There was a statistically significant decrease in pseudotumor size (the length between the anterior border of the odontoid process to the posterior border of the pseudotumor) from a mean length of 17.7 to 14.9 mm (P