Factors Affecting the Outcomes of Traumatic Atlanto-Occipital Dislocations in Adults: A Systematic Review

• Published in: World neurosurgery 2022-06, Vol.162, p.e568-e579
• Main Authors: Grin, Andrey, Lvov, Ivan, Talypov, Aleksandr, Kordonskiy, Anton, Godkov, Ivan, Khushnazarov, Ulugbek, Krylov, Vladimir
• Format: Article
• Language: English
• Subjects: Atlanto-occipital dislocation; Craniovertebral injury; Halo immobilization; Occipitocervical fixation
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2022.03.055

The objectives of this study were to conduct a systematic review of the literature to determine the optimal treatment method for patients with atlanto-occipital dislocation (AOD) and to identify possible factors influencing their outcomes. We conducted a systematic review of the PubMed database between January 1966 and December 2020. The main inclusion criterion was articles that discussed AOD treatment methods, and outcome descriptions were selected for analysis. Intergroup differences were assessed using nonparametric statistical methods. Of the 657 articles identified initially, only 54 met the inclusion criteria, resulting in data from 139 patients. Type I or II AODs were more frequent in patients injured in road traffic accidents, whereas type III AODs were more frequent in patients with catatrauma (P = 0.027). Spinal cord injury was more frequently observed in patients with types I and II AODs than in those with type III AOD (P = 0.026). Improved outcomes were more common in the surgical treatment group (P