The goal of this observational study was to learn about the long-term clinical efficacy of conservative treatment in atlantoaxial dislocation patients without neurological deficit. The main question it aims to answer is:
Is surgical intervention always necessary in atlantoaxial dislocation patients without nerve deficit?
Patients who refuse surgical intervention will continue to be treated conservatively. Clinical outcomes will be summarized over five years of follow-up
The patients meet the diagnostic criteria for atlantoaxial dislocation, that is, the ADI exceeds the normal range: it is over 3 mm in adults and over 5 mm in children.
The patients have no clinical manifestations of the nervous system, including occipital neuralgia, manifestations of cranial nerve impairment (such as dysphagia, dysarthria, nystagmus, etc.) and manifestations of spinal cord impairment (such as unsteadiness in holding objects, unsteady gait, decreased limb muscle strength, etc.).
After fully understanding their own conditions as well as the advantages, disadvantages and risks of both conservative treatment and surgical treatment, the patients can choose the initial treatment method on their own. If they choose conservative treatment, they will be included in the conservative treatment. If they choose surgical treatment, they will be included in the surgical intervention group.
Patients who have undergone surgeries in the cranio-cervical junction previously.
Patients with infections or tumors in the cranio-cervical junction.
Patients with fresh fractures in the cranio-cervical junction.
Patients with clinical manifestations of nerve deficit.
Peking University Third Hospital
Lead sponsor
The First Affiliated Hospital of Zhengzhou University
Collaborator
Shanxi Medical University Second Hospital
Collaborator
Sir Run Run Shaw Hospital
Collaborator
Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Collaborator
Hebei Medical University Third Hospital
Collaborator
Shanxi Bethune Hospital
Collaborator
Daping Hospital of Army Medical University
Collaborator
Shengjing Hospital
Collaborator
Tianjin People's Hospital
Collaborator
First Affiliated Hospital of Kunming Medical University
Collaborator
Guilin Medical University, China
Collaborator