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Feasibility of occipital condyle screw placement in patients with Chiari malformation type I: a computed tomography-based morphometric study

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Abstract

Background

The occipital condyle (OC) screw is an alternative technique for occipitocervical fixation that is especially suitable for revision surgery in patients with Chiari malformation type I (CMI). This study aimed to investigate the feasibility and safety of this technique in patients with CMI.

Methods

The CT data of 73 CMI patients and 73 healthy controls were retrospectively analyzed. The dimensions of OCs, including length, width, height, sagittal angle, and screw length, were measured in the axial, sagittal, and coronal planes using CT images. The OC available height was measured in the reconstructed oblique parasagittal plane of the trajectory.

Results

The mean length, width, and height of OCs in CMI patients were 17.79 ± 2.31 mm, 11.20 ± 1.28 mm, and 5.87 ± 1.29 mm, respectively. All OC dimensions were significantly smaller in CMI patients compared with healthy controls. The mean screw length and sagittal angle were 19.13 ± 1.97 mm and 33.94° ± 5.43°, respectively. The mean OC available height was 6.36 ± 1.59 mm. According to criteria based on OC available height and width, 52.1% (76/146) of OCs in CMI patients could safely accommodate a 3.5-mm-diameter screw.

Conclusions

The OC screw is feasible in approximately half of OCs in CMI patients. Careful morphometric analyses and personalized surgical plans are necessary for the success of this operation in CMI patients.

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Abbreviations

CMI:

Chiari malformation type I

CVJ:

Craniovertebral junction

OC:

Occipital condyle

OCS:

Occipital condyle screw

PFD:

Posterior fossa decompression

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Acknowledgments

The authors sincerely thank all the study participants.

Funding

The National Key Research and Development Program of China provided financial support in the form of grant funding (grant numbers 2018YFC1002500 and 2019YFC1005100). The sponsor had no role in the design or conduct of this research.

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Author notes

  1. Ming Wan and Rui Zong contributed equally to this work.

Authors and Affiliations

  1. Medical School of Chinese PLA, 28 Fuxing Road, Haidian District, Beijing, 100853, People’s Republic of China

    Ming Wan, Rui Zong & Xin-Guang Yu

  2. Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing, China

    Guang-Yu Qiao, Huai-Yu Tong, Ai-Jia Shang, Yi-Heng Yin & Xin-Guang Yu

  3. Medical Big Data Centre, Chinese PLA General Hospital, Beijing, China

    Hong-Li Xu

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  1. Ming Wan
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Contributions

Conceptualization and funding acquisition: Xin-Guang Yu; Formal analysis: Ming Wan; Investigation: Ming Wan and Rui Zong; Resources: Hong-Li Xu, Guang-Yu Qiao, Huai-Yu Tong, Ai-Jia Shang, and Yi-Heng Yin; Writing-original draft: Ming Wan; Writing-review and editing: Rui Zong.

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Correspondence to Xin-Guang Yu.

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Informed consent was obtained from all individual participants included in the study.

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Wan, M., Zong, R., Xu, HL. et al. Feasibility of occipital condyle screw placement in patients with Chiari malformation type I: a computed tomography-based morphometric study. Acta Neurochir 163, 1569–1575 (2021). https://doi.org/10.1007/s00701-021-04714-5

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  • DOI: https://doi.org/10.1007/s00701-021-04714-5

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