Medical and quantitative evaluation of sufferers with topped dens syndrome.
J Neurol Sci. 2017 Might 15;376:52-59
Authors: Takahashi T, Tamura M, Takasu T, Kamei S
BACKGROUND: Topped dens syndrome (CDS) is a radioclinical entity outlined by calcium deposition on the transverse ligament of atlas (TLA). On this research, the novel semi-quantitative diagnostic standards for CDS to guage the diploma of calcification on TLA by cervical CT are proposed.
METHOD: From January 2010 to September 2014, 35 sufferers who have been identified with CDS by cervical CT have been adopted as topics on this research. Based mostly on novel standards, calcium deposition on TLA was categorized into “Stage” and “Grade”, to make a rating, which was evaluated semi-quantitatively. The correlation between calcification rating and CRP degree or ache rating, and the results of remedies, comparable to NSAIDs and corticosteroids, have been statistically analyzed.
RESULTS: The full calcification rating from added “Stage” and “Grade” scores demonstrated a considerably sturdy and linear correlation with CRP degree (R2=zero.823, **p<zero.01). Within the a number of comparability take a look at for the therapy results, vital enchancment of the CRP degree and ache rating have been demonstrated after corticosteroid remedy (**p<zero.01) in contrast with NSAIDs. Within the conditional logistic regression evaluation, the speedy finish of corticosteroid remedy was an unbiased danger issue for relapse of cervico-occipital ache [OR=50.761, *p=0.0419].
CONCLUSION: The diploma of calcification on TLA evaluated by the novel semi-quantitative standards considerably correlated with CRP degree. Within the therapy of CDS, it’s endorsed low dosage (15-30mg) of corticosteroids be used as first-line medication quite than typical NSAID remedy. Moreover, additionally it is advisable to progressively lower the dosage of corticosteroids.
PMID: 28431628 [PubMed – indexed for MEDLINE]