{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:03:02Z","timestamp":1791576182532,"version":"4.3.4"},"reference-count":72,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The atlantoaxial intra-articular distraction and fusion technique involves intra-articular release, distraction, and cage implantation and is commonly used to treat craniovertebral bony malformations. Polyetheretherketone (PEEK) cages for C1\u20132 intra-articular fusion have been in use for over a decade. Three-dimensional printing is an emerging approach in spinal surgery, and several studies have explored 3D-printed porous titanium alloy (3DPT) cages for interbody fusion. However, there is limited research on their application and comparisons for C1\u20132 intra-articular fusion. In this study, the authors aimed to compare the outcomes of C1\u20132 intra-articular PEEK cages with those of 3DPT cages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Clinical data from patients with craniovertebral anomalies treated with C1\u20132 intra-articular cage implantation were retrospectively analyzed. Midsagittal parameters were compared between PEEK and 3DPT and at 3 time points: preoperatively, postoperatively, and follow-up. Other assessments included clinical remission, reduction loss, fusion failure, cage micromotion, and screw-rod failure. Univariate comparisons were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Records of 60 patients were reviewed, with a mean age of 43.75 \u00b1 13.48 years; basilar invagination was the most common deformity. The 3DPT and PEEK cages demonstrated comparable immediate reduction effects. However, during follow-up, the 3DPT cage exhibited superior reduction maintenance, enhanced fusion rates, and reduced cage micromotion. Fusion rates were 100% and 80.6% in the 3DPT and PEEK groups, respectively. Fusion failure was associated with clinical nonremission, PEEK cage, deformity relapse, reduction loss, and cage micromotion, but was not associated with screw-rod construct failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Fusion failure significantly undermines long-term outcomes. The 3DPT cage is a viable option for improving long-term results by minimizing loss of reduction, preventing fusion failure, and reducing cage micromotion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.3.spine241148","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T15:56:35Z","timestamp":1757951795000},"page":"361-374","source":"Crossref","is-referenced-by-count":2,"title":["Comparison of outcomes between 3D-printed porous titanium alloy and polyetheretherketone cages for atlantoaxial intra-articular fusion in craniovertebral malformations"],"prefix":"10.3171","volume":"43","author":[{"given":"Qiang","family":"Jian","sequence":"first","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhe","family":"Hou","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"},{"name":"Department of Neurosurgery, Beijing Luhe Hospital, Capital Medical University, Beijing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingang","family":"Zhao","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cong","family":"Liang","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinqian","family":"Wang","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun","family":"Wu","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jichao","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, People\u2019s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Fan","sequence":"additional","affiliation":[{"name":"Spine Center, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"World Neurosurg","first-page":"e629","article-title":"Basilar invagination: a tilt of the foramen magnum","volume":"164","author":"Jian Q","year":"2022","unstructured":"Jian Q, Zhang B, Jian F, Bo X, Chen Z. Basilar invagination: a tilt of the foramen magnum. World Neurosurg. 2022;164:e629\u2013e635."},{"issue":"2","key":"b2","series-title":"Spine J","first-page":"389","article-title":"Biomechanical differences of three cephalic fixation methods for patients with basilar invagination and atlantoaxial dislocation in the setting of congenital atlas occipitalization: a finite element analysis","volume":"25","author":"Jian Q","year":"2025","unstructured":"Jian Q, Qin S, Hou Z,  Biomechanical differences of three cephalic fixation methods for patients with basilar invagination and atlantoaxial dislocation in the setting of congenital atlas occipitalization: a finite element analysis. 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Distraction, compression, and extension reduction of basilar invagination and atlantoaxial dislocation: a novel pilot technique. Neurosurgery. 2013;72(6):1040\u20131053."},{"issue":"3","key":"b6","series-title":"J Neurosurg Spine","first-page":"294","article-title":"Comprehensive drilling of the C1-2 facets to achieve direct posterior reduction in irreducible atlantoaxial dislocation","volume":"23","author":"Salunke P","year":"2015","unstructured":"Salunke P, Sahoo SK, Deepak AN, Ghuman MS, Khandelwal NK. Comprehensive drilling of the C1-2 facets to achieve direct posterior reduction in irreducible atlantoaxial dislocation. 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Neurospine. 2022;19(1):202\u2013211."},{"issue":"2","key":"b9","series-title":"Neurospine","first-page":"451","article-title":"Three-dimensional-printed titanium versus polyetheretherketone cages for lumbar interbody fusion: a systematic review of comparative in vitro, animal, and human studies","volume":"20","author":"Patel NA","year":"2023","unstructured":"Patel NA, O\u2019Bryant S, Rogers CD,  Three-dimensional-printed titanium versus polyetheretherketone cages for lumbar interbody fusion: a systematic review of comparative in vitro, animal, and human studies. 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