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International Journal of Neurology and Neurosurgery

Volume  11, Issue 3, July-September 2019, Pages 197-203
 

Original Article

An Analytical Study of Posterior Atlanto Dental Interval As A Prognosticator in Patients with Bony Craniovertebral Junction Anomalies

DR Shankar1, Suresh Babu Thirumal2

1Senior Associate Professor, 2Associate Professor, Institute of Neurosuregry, Madras Medical College Chennai, Tamil Nadu 600003, India.

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.11319.5

Abstract

Introduction: The Posterior Atlanto Dental Interval (PADI) is the effective canal diameter, measured from the posterior surface of the Dens to the Posterior arch of the Atlas. Objective: To study the role of PADI, in producing the symptoms and also the postoperative outcome in patients with bony CranioVertebral Junction anomalies. Materials and Methods: About 34 patients from March 2016 to Oct 2018 who were operated at Rajiv Gandhi government General Hospital,were prospectively studied. The PADI and the preoperative & Postoperative“Kumar and Kalra Score “ (K and K score) was calculated for all patients. The patients were divided into three groups based on the PADI, into 5 mm to 10 mm group, 10 mm to 15 mm group and >15 mm group. Results: There were 26 male (79.1%) patients and 8 female patients (20.9%) with the mean age of presentation 26.10 years. The PADI was 8.012 mm with range of 5–15 mm. The mean Pre-operative K and K score was 19.52. There were 19 patients with, PADI of 5 mm to 15 mm,12 patients with PADI of 15 mm to 20 mm and 3 patients with PADI more than 20 mm.The correlation coefficient, between the PADI and the Preoperative & Postoperative “K & K Score“ at the time of discharge, 3 months & 6 months postoperative were 0.404, 0.320 and 0.284 respectively. Conclusions: The correlation between PADI and the Preoperative K and K score, was strongest in patients with PADI of about 5 to 10 mm. The correlation between PADI and the Preoperative K & K score became less stronger, as the follow- up period was increased even though they are significantly related to each other.

Keywords: Posterior Atlanto Dental Interval; Craniovertebral Junction anomalies; Kumar and Kalra Score.


Corresponding Author : Suresh Babu Thirumal