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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Rotation and translation: range of motion of the C1/C2 facet joints – a computed tomography (CT) analysis in non-trauma patients

Rotation und Translation: Bewegungsumfang der Facettgelenke C1/C2 – eine CT-Analyse bei Nicht-Trauma-Patienten

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  • Katharina Pöhlmann - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland
  • presenting/speaker Amir Amini - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland
  • Belal Neyazi - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland
  • Karl Hartmann - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland
  • Aiden Haghikia - Universitätsklinikum Magdeburg, Neurologie, Magdeburg, Deutschland
  • I. Erol Sandalcioglu - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland
  • Klaus-Peter Stein - Universitätsklinikum Magdeburg, Klinik für Neurochirurgie, Magdeburg, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocP141

doi: 10.3205/22dgnc454, urn:nbn:de:0183-22dgnc4549

Published: May 25, 2022

© 2022 Pöhlmann et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: CT is widely used in initial emergency settings and represents the gold standard for the assessment of spinal injury. Our study aimed to analyze the extent of rotatory and translatory range of motion of the facet joints C1/C2 in spinal CT scans of non-trauma patients and its potential role in upper cervical spine trauma diagnosis.

Methods: Spinal CT images of emergency patients with suspected stroke were evaluated according to a standardized protocol. Primary attention was paid to the position of the C1/C2 facet joints with particular reference to segmental rotation and translation.

Results: CT scans of 352 patients (period 2020-2021) were included. The facet joints C1/C2 showed large morphological variability. Opposite protrusion of respective joint sections in ventral or dorsal direction, caused by rotation of C1 against C2, was found in n=260 cases (range 1-8mm, mean 3.1mm±1.5mm). Corresponding opposite protrusion consecutively increased with increasing rotation (angle). Translational bilateral, concordant joint protrusions were found in n=81 cases, whereas the mean extent of protrusion in these cases was smaller (Range 1-8mm, Mean 2.9mm±1.4mm; no rotation and no translation n=11). Applying the physiological range of the atlanto-dental distance (3mm) according to la Caffiniere, only one patient was found in our collective with bilateral, concordant joint protrusion of >3mm.

Conclusion: A bilateral and concordant translation of the facet joints C1/C2, exceeding a physiological range of motion, is a rare event in the non-traumatic patient population. Thus, the division of the facet joints C1/C2 may be of help in the assessment of atlanto-axial instability, especially in odontoid fractures.