{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:20:50Z","timestamp":1790382050814,"version":"4.1.0"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,12,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Conventional surgical procedures for atlantoaxial instability or dislocation (AAI\/D) have been associated with a high prevalence of postoperative occipitocervical pain and dysfunction, as well as substantial perioperative blood loss. We hypothesized that minimally invasive surgery for posterior atlantoaxial lateral mass joint fusion (MIS-PALF), a procedure that can largely avoid disruption of suboccipital musculature, would be superior to the standard Goel-Harms technique in terms of postoperative pain and perioperative blood loss.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This was a prospective cohort study of patients undergoing MIS-PALF for AAI\/D at Peking University Third Hospital\u2019s Department of Orthopaedics from January 2021 to December 2021 and a historical control group of patients with the same diagnoses who were treated with the Goel-Harms technique. The duration of surgery, perioperative blood loss, postoperative length of hospital stay, postoperative body temperature, pain, supplementary use of narcotics, spinal cord function\/improvement (assessed using the Japanese Orthopaedic Association [JOA] scores), reduction of AAI\/D (determined based on radiographic parameters), rate of successful fusion, and complication rate were all compared between the 2 groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No significant differences were noted between the groups (43 MIS-PALF cases, 86 control cases) regarding baseline data, operative time, spinal cord function or improvement, reduction of AAI\/D, rate of successful fusion, and complication rate. MIS-PALF was associated with significantly less perioperative blood loss, a shorter postoperative hospital stay (decreased by 30.8%), lower intensity and frequency of postoperative pain (decreased by 10.6% and 61.9%, respectively), less need for supplementary narcotics, and less frequent postoperative fever (decreased by 48.7%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This was the first prospective cohort study of which we are aware on minimally invasive procedures for atlantoaxial fusion. Clinical efficacy (AAI\/D reduction, rate of successful atlantoaxial fusion, JOA score improvement), efficiency (operative time), and safety (complications) of MIS-PALF appeared to be noninferior to those of the Goel-Harms technique. MIS-PALF was superior in terms of postoperative occipitocervical pain and length of hospital stay, both of which directly affect overall patient satisfaction and postoperative recovery of quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level II<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.23.01464","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T14:00:32Z","timestamp":1726668032000},"page":"2215-2222","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Minimally Invasive Surgery for Posterior Atlantoaxial Lateral Mass Joint Fusion (MIS-PALF)"],"prefix":"10.2106","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0720-8635","authenticated-orcid":false,"given":"Kan-Lin","family":"Hung","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, Peking University Third Hospital, Beijing, People\u2019s Republic of China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8056-7458","authenticated-orcid":false,"given":"Shilin","family":"Xue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Peking University Third Hospital, Beijing, People\u2019s Republic of China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Beijing, People\u2019s Republic of China"},{"name":"Beijing Key Laboratory of Spinal Disease Research, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5271-5775","authenticated-orcid":false,"given":"Guodong","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Peking University Third Hospital, Beijing, People\u2019s Republic of China"},{"name":"Engineering Research Center of Bone and Joint Precision Medicine, Beijing, People\u2019s Republic of China"},{"name":"Beijing 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