Journal article
The Application of the Revised Condyle–C1 Interval Method to Diagnose Traumatic Atlanto-occipital Dissociation in Adults
Global spine journal, Vol.6(6), pp.529-534
09/2016
DOI: 10.1055/s-0035-1569058
PMCID: PMC4993610
PMID: 27555993
Abstract
Abstract
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.
Details
- Title: Subtitle
- The Application of the Revised Condyle–C1 Interval Method to Diagnose Traumatic Atlanto-occipital Dissociation in Adults
- Creators
- Nader S Dahdaleh - Department of Neurological Surgery, Northwestern UniversityRyan Khanna - Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United StatesArnold H Menezes - Department of Neurological Surgery, University of Iowa, Carver School of Medicine, Iowa City, Iowa, United StatesZachary A Smith - Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United StatesStephanus V Viljoen - Department of Neurological Surgery, University of Iowa, Carver School of Medicine, Iowa City, Iowa, United StatesTyler R Koski - Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United StatesPatrick W Hitchon - Department of Neurological Surgery, University of Iowa, Carver School of Medicine, Iowa City, Iowa, United StatesBrian J Dlouhy - Department of Neurological Surgery, University of Iowa, Carver School of Medicine, Iowa City, Iowa, United States
- Resource Type
- Journal article
- Publication Details
- Global spine journal, Vol.6(6), pp.529-534
- DOI
- 10.1055/s-0035-1569058
- PMID
- 27555993
- PMCID
- PMC4993610
- NLM abbreviation
- Global Spine J
- ISSN
- 2192-5682
- eISSN
- 2192-5690
- Publisher
- Georg Thieme Verlag KG; Stuttgart · New York
- Language
- English
- Date published
- 09/2016
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040004502771
Metrics
31 Record Views