Study: Intraarticular Bone Grafting in Atlantoaxial facet jo
A Study was conducted to investigate the necessity of nonstructural or structural intraarticular bone grafting in atlantoaxial facet joints via a posterior approach and the influence by the presence of basilar invagination (BI).

Patients who underwent posterior atlantoaxial or occipitocervical arthrodesis surgery were retrospectively reviewed. Operation records, preoperative and postoperative clinical status, and radiological films were analyzed.

Results:
--33 patients underwent posterior facet joint release followed by intraarticular bone grafting were enrolled finally.

--24 nonstructural and 9 structural grafting were performed. The average follow-up was 32.15±6.73 months.

--Among them, 1 implant failure occurred, and 32 achieved satisfactory neurological outcomes, including 28 complete and 4 acceptable reductions with complete fusion within 6 months.

--For patients without BI, structural and nonstructural grafting showed no significant difference in terms of reduction maintenance (100% vs 73.33%), while for those with BI, structural grafting significantly increased the postoperative height of the joint space and maintained it much better than nonstructural grafting (88.89% vs 20.00%), contributing notably to BI correction.

In the case of lateral mass collapse or when BI correction is required, intraarticular structural bone grafting in atlantoaxial facet joints offers the advantage of maintaining anterior column height; otherwise, nonstructural bone grafting is sufficient.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02630-z
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