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Inclination of the odontoid process in the pediatric Chiari I malformation.
J Neurosurg. 2003 Jan; 98(1 Suppl):43-9.JN

Abstract

OBJECT

The quantitative analysis of odontoid process angulation has had scant attention in the Chiari I malformation population. In this study the authors sought to elucidate the correlation between posterior angulation of the odontoid process and patients with Chiari I malformation.

METHODS

Magnetic resonance images of the craniocervical junction obtained in 100 children with Chiari I malformation and in 50 children with normal intracranial anatomy (controls) were analyzed. Specific attention was focused on measuring the degree of angulation of the odontoid process and assigning a score to the various degrees. Postoperative outcome following posterior cranial fossa decompression was then correlated to grades of angulation. Other measurements included midsagittal lengths of the foramen magnum and basiocciput, the authors' institutions' previously documented pB-C2 line (a line drawn perpendicular to one drawn between the basion and the posterior aspect of the C-2 body), level of the obex from a midpoint of the McRae line, and the extent of tonsillar herniation. Higher grades of odontoid angulation (retroflexion) were found to be more frequently associated with syringomyelia and particularly holocord syringes. Higher grades of angulation were more common in female patients and were often found to have obices that were caudally displaced greater than three standard deviations below normal.

CONCLUSIONS

These results not only confirm prior reports of an increased incidence of a retroflexed odontoid process in Chiari I malformation but quantitatively define grades of inclination. Grades of angulation were not found to correlate with postoperative outcome. It is the authors' hopes that these data add to our current limited understanding of the mechanisms involved in hindbrain herniation.

Authors+Show Affiliations

Department of Cell Biology, University of Alabama at Birmingham, Birmingham, Alabama, USA. richard.tubbs@ccc.uab.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12546387

Citation

Tubbs, R Shane, et al. "Inclination of the Odontoid Process in the Pediatric Chiari I Malformation." Journal of Neurosurgery, vol. 98, no. 1 Suppl, 2003, pp. 43-9.
Tubbs RS, Wellons JC, Blount JP, et al. Inclination of the odontoid process in the pediatric Chiari I malformation. J Neurosurg. 2003;98(1 Suppl):43-9.
Tubbs, R. S., Wellons, J. C., Blount, J. P., Grabb, P. A., & Oakes, W. J. (2003). Inclination of the odontoid process in the pediatric Chiari I malformation. Journal of Neurosurgery, 98(1 Suppl), 43-9.
Tubbs RS, et al. Inclination of the Odontoid Process in the Pediatric Chiari I Malformation. J Neurosurg. 2003;98(1 Suppl):43-9. PubMed PMID: 12546387.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inclination of the odontoid process in the pediatric Chiari I malformation. AU - Tubbs,R Shane, AU - Wellons,John C,3rd AU - Blount,Jeffrey P, AU - Grabb,Paul A, AU - Oakes,W Jerry, PY - 2003/1/28/pubmed PY - 2003/2/14/medline PY - 2003/1/28/entrez SP - 43 EP - 9 JF - Journal of neurosurgery JO - J Neurosurg VL - 98 IS - 1 Suppl N2 - OBJECT: The quantitative analysis of odontoid process angulation has had scant attention in the Chiari I malformation population. In this study the authors sought to elucidate the correlation between posterior angulation of the odontoid process and patients with Chiari I malformation. METHODS: Magnetic resonance images of the craniocervical junction obtained in 100 children with Chiari I malformation and in 50 children with normal intracranial anatomy (controls) were analyzed. Specific attention was focused on measuring the degree of angulation of the odontoid process and assigning a score to the various degrees. Postoperative outcome following posterior cranial fossa decompression was then correlated to grades of angulation. Other measurements included midsagittal lengths of the foramen magnum and basiocciput, the authors' institutions' previously documented pB-C2 line (a line drawn perpendicular to one drawn between the basion and the posterior aspect of the C-2 body), level of the obex from a midpoint of the McRae line, and the extent of tonsillar herniation. Higher grades of odontoid angulation (retroflexion) were found to be more frequently associated with syringomyelia and particularly holocord syringes. Higher grades of angulation were more common in female patients and were often found to have obices that were caudally displaced greater than three standard deviations below normal. CONCLUSIONS: These results not only confirm prior reports of an increased incidence of a retroflexed odontoid process in Chiari I malformation but quantitatively define grades of inclination. Grades of angulation were not found to correlate with postoperative outcome. It is the authors' hopes that these data add to our current limited understanding of the mechanisms involved in hindbrain herniation. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/12546387/Inclination_of_the_odontoid_process_in_the_pediatric_Chiari_I_malformation_ DB - PRIME DP - Unbound Medicine ER -