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A Prospective Study of Natural History and Clinical Outcomes for Basilar Invagination
Since basilar invagination was reported, its pathogenesis has been considered both primary and secondary. Surgical treatment methods emerged in an endless stream, and a hundred schools of thought contend. However, the link between the symptoms and imaging has not been studied in detail. We prospectively enrolled patients with basilar depression, and then explored the natural history of the disease and the clinical outcomes of early intervention.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Goel A Type Basilar Invagination | 1) ADI>3mm in adults, or ADI>5mm in child. |
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| Goel B Type Basilar Invagination |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Posterior facet distraction and fusion | Procedure | With the patient in prone position, cervical traction was only intraoperatively after anesthesia with weights of approximately 5-8 kg during surgery. Monitoring of the spinal cord with motor evoked potential and somatosensory evoked potential were used throughout the surgery. Using a posterior midline incision, the occiput to the C2 spinous process was surgically exposed, separated to the lateral edge of the C1-2 joint, and cut off at the C2 nerve root to expose the C1-2 articular surface Quantitative reduction techniques included the following steps .1) Facet joint release and cage implantation technique 2)Adjusting POCA by cantilever and occipitocervical fixation technique. |
| Measure | Description | Time Frame |
|---|---|---|
| improved symptoms | The symptoms improved after the opration or natural condition.（JOA scores and SF-12 scores） | 1 months postoperatively |
| improved symptoms | The symptoms improved after the opration or natural condition.（JOA scores and SF-12 scores） | 3 months postoperatively |
| improved symptoms | The symptoms improved after the opration or natural condition.（JOA scores and SF-12 scores） | 6 months postoperatively |
| improved radiology | improved ADI, CCA, CTA ; The basilar invagination reduced | 1 months postoperatively |
| improved radiology | improved ADI, CCA, CTA ; The basilar invagination reduced | 3 months postoperatively |
| improved radiology | improved ADI, CCA, CTA ; The basilar invagination reduced | 6 months postoperatively |
| operation complication | operation complication（Excessive bleeding, bronchopneumonia, vertebral artery injury ） | 1 months postoperatively |
| operation complication | operation complication（Excessive bleeding, bronchopneumonia, vertebral artery injury ） |
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Inclusion Criteria:
Exclusion Criteria:
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patients with primary basilar depression
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| Name | Affiliation | Role |
|---|---|---|
| Zan Chen, MD. PHD. | Xuanwu Hospital, Beijing | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Xuanwu Hospital， Capital Medical University | Beijing | 100053 | China |
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| ID | Term |
|---|---|
| D050939 | Gene Fusion |
| ID | Term |
|---|---|
| D011995 | Recombination, Genetic |
| D055614 | Genetic Phenomena |
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|
| 3 months postoperatively |
| operation complication | operation complication（Excessive bleeding, bronchopneumonia, vertebral artery injury ） | 6 months postoperatively |