PMID- 27555993
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160824
LR  - 20220331
IS  - 2192-5682 (Print)
IS  - 2192-5690 (Electronic)
IS  - 2192-5682 (Linking)
VI  - 6
IP  - 6
DP  - 2016 Sep
TI  - The Application of the Revised Condyle-C1 Interval Method to Diagnose Traumatic 
      Atlanto-occipital Dissociation in Adults.
PG  - 529-34
LID - 10.1055/s-0035-1569058 [doi]
AB  - STUDY DESIGN: Retrospective study. OBJECTIVE: Traumatic atlanto-occipital 
      dissociation (AOD) remains a diagnostic challenge, and delay in diagnosis is 
      associated with catastrophic outcomes. Recently, a revised version of the 
      condyl-C1 interval (CCI) utilizing parasagittal computed tomography (CT) 
      reconstruction was used successfully with unilateral dislocation of 2.5 mm at the 
      level of that joint diagnostic of AOD. We report the utility of this simple 
      technique in the diagnosis of six patients with AOD. METHODS: Two blinded 
      neurosurgeons assessed CTs of six patients with AOD and 30 patients without AOD. 
      The following methodologies were applied: basion-dens interval (BDI), 
      basion-axial interval (BAI), Lee X-lines, Powers ratio, CCI, and revised CCI. The 
      average sensitivity, specificity, positive predictive value (PPV) and negative 
      predictive value (NPV) as well as the kappa statistic indicating interrater 
      reliability of each method were investigated. RESULTS: The average sensitivity 
      for BDI, BAI, Lee X-lines, Power ratio, CCI, and revised CCI was 0.75, 0.33, 
      0.67, 0.50, 1.00, and 1.00, respectively. The average specificity was 1.00, 1.00, 
      0.50, 1.00, 0.94, and 1.00, respectively. The average PPV was 1.00, 1.00, 0.25, 
      1.00, 0.80, and 1.00, respectively. The average NPV was 0.96, 0.88, 0.89, 0.91, 
      1.00, and 1.00, respectively, and the kappa statistic was 0.57, 0.25, 0.25, 0.20, 
      1.00, and 1.00, respectively. CONCLUSION: Based on this study, the revised CCI 
      method is simple yet the most sensitive and reliable technique for the diagnosis 
      of AOD.
FAU - Dahdaleh, Nader S
AU  - Dahdaleh NS
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, United States.
FAU - Khanna, Ryan
AU  - Khanna R
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, United States.
FAU - Menezes, Arnold H
AU  - Menezes AH
AD  - Department of Neurological Surgery, University of Iowa, Carver School of 
      Medicine, Iowa City, Iowa, United States.
FAU - Smith, Zachary A
AU  - Smith ZA
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, United States.
FAU - Viljoen, Stephanus V
AU  - Viljoen SV
AD  - Department of Neurological Surgery, University of Iowa, Carver School of 
      Medicine, Iowa City, Iowa, United States.
FAU - Koski, Tyler R
AU  - Koski TR
AD  - Department of Neurological Surgery, Northwestern University Feinberg School of 
      Medicine, Chicago, Illinois, United States.
FAU - Hitchon, Patrick W
AU  - Hitchon PW
AD  - Department of Neurological Surgery, University of Iowa, Carver School of 
      Medicine, Iowa City, Iowa, United States.
FAU - Dlouhy, Brian J
AU  - Dlouhy BJ
AD  - Department of Neurological Surgery, University of Iowa, Carver School of 
      Medicine, Iowa City, Iowa, United States.
LA  - eng
PT  - Journal Article
DEP - 20151126
PL  - England
TA  - Global Spine J
JT  - Global spine journal
JID - 101596156
PMC - PMC4993610
OTO - NOTNLM
OT  - atlanto-occipital dissociation
OT  - craniovertebral junction
OT  - dissociation
OT  - occipitocervical dislocation
COIS- Disclosures Nader S. Dahdaleh: none Ryan Khanna: none Arnold H. Menezes: none 
      Zachary A. Smith: none Stephanus V. Viljoen: Personal fees (Medtronic) Tyler R. 
      Koski: Consultant (Medtronic, Nuvasive, SpineWave); Stock ownership (Nuvasive); 
      Honorarium (Depuy) Patrick W. Hitchon: none Brian J. Dlouhy: none
EDAT- 2016/08/25 06:00
MHDA- 2016/08/25 06:01
PMCR- 2016/09/01
CRDT- 2016/08/25 06:00
PHST- 2015/06/15 00:00 [received]
PHST- 2015/09/22 00:00 [accepted]
PHST- 2016/08/25 06:00 [entrez]
PHST- 2016/08/25 06:00 [pubmed]
PHST- 2016/08/25 06:01 [medline]
PHST- 2016/09/01 00:00 [pmc-release]
AID - 1500094 [pii]
AID - 10.1055/s-0035-1569058 [doi]
PST - ppublish
SO  - Global Spine J. 2016 Sep;6(6):529-34. doi: 10.1055/s-0035-1569058. Epub 2015 Nov 
      26.