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A detailed morphologic and functional magnetic resonance imaging study of the craniocervical junction in adolescent idiopathic scoliosis.
Spine (Phila Pa 1976). 2007 Jul 01; 32(15):1667-74.S

Abstract

STUDY DESIGN

Conventional and phase-contrast magnetic resonance (MR) imaging were used to evaluate the morphology and cerebrospinal fluid (CSF) flow dynamics at craniocervical junction in adolescent idiopathic scoliosis (AIS).

OBJECTIVES

To determine the morphology of cerebellar tonsil, foramen magnum, and dynamic flow of CSF at the craniocervical junction in AIS patients versus normal controls and their correlation with somatosensory cortical evoked potentials (SSEP).

SUMMARY OF BACKGROUND DATA

Previous studies have documented obstructed CSF flow in patients with Chiari I malformation. Low-lying cerebellar tonsils and syringomyelia are also observed in AIS patients. We sought to investigate whether disturbed CSF flow is also evident in AIS subjects at the foramen magnum level and its association with level of cerebellar tonsils and dimensions of foramen magnum.

METHODS

Conventional and phase-contrast MR were performed in 105 adolescent girls (69 AIS subjects and 36 age-matched controls). Measurements of cerebellar tonsillar level related to the basion-opsithion (BO) line, anteroposterior (AP), transverse (TS) diameter, and area of foramen magnum, and peak velocity of CSF flow in both the anterior and posterior subarachnoid space through foramen magnum were obtained. Correlations were made among different parameters and SSEP findings.

RESULTS

A total of 42% of subjects in the AIS group had the cerebellar tonsillar tip positioned 1 mm below the BO line. The cerebellar tonsillar level in AIS subjects was significantly lower than the median tonsillar level in normal controls (P < 0.01). The AP diameter and area of foramen magnum were significantly larger in AIS subjects when compared with normal controls (P < 0.05), but the peak CSF velocities through foramen magnum showed no significant difference (P > 0.05).

CONCLUSION

Peak CSF velocities through foramen magnum were not significantly different in AIS subjects despite the presence of low-lying cerebellar tonsils. This might be explained by the compensatory effect of larger foramen magnum in AIS subjects.

Authors+Show Affiliations

Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong. winnie@med.cuhk.edu.hkNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17621216

Citation

Chu, Winnie C W., et al. "A Detailed Morphologic and Functional Magnetic Resonance Imaging Study of the Craniocervical Junction in Adolescent Idiopathic Scoliosis." Spine, vol. 32, no. 15, 2007, pp. 1667-74.
Chu WC, Man GC, Lam WW, et al. A detailed morphologic and functional magnetic resonance imaging study of the craniocervical junction in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2007;32(15):1667-74.
Chu, W. C., Man, G. C., Lam, W. W., Yeung, B. H., Chau, W. W., Ng, B. K., Lam, T. P., Lee, K. M., & Cheng, J. C. (2007). A detailed morphologic and functional magnetic resonance imaging study of the craniocervical junction in adolescent idiopathic scoliosis. Spine, 32(15), 1667-74.
Chu WC, et al. A Detailed Morphologic and Functional Magnetic Resonance Imaging Study of the Craniocervical Junction in Adolescent Idiopathic Scoliosis. Spine (Phila Pa 1976). 2007 Jul 1;32(15):1667-74. PubMed PMID: 17621216.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A detailed morphologic and functional magnetic resonance imaging study of the craniocervical junction in adolescent idiopathic scoliosis. AU - Chu,Winnie C W, AU - Man,Gene C W, AU - Lam,Wynnie W M, AU - Yeung,Benson H Y, AU - Chau,Wai-Wang, AU - Ng,Bobby K W, AU - Lam,Tsz-Ping, AU - Lee,Kwong-Man, AU - Cheng,Jack C Y, PY - 2007/7/11/pubmed PY - 2007/8/9/medline PY - 2007/7/11/entrez SP - 1667 EP - 74 JF - Spine JO - Spine (Phila Pa 1976) VL - 32 IS - 15 N2 - STUDY DESIGN: Conventional and phase-contrast magnetic resonance (MR) imaging were used to evaluate the morphology and cerebrospinal fluid (CSF) flow dynamics at craniocervical junction in adolescent idiopathic scoliosis (AIS). OBJECTIVES: To determine the morphology of cerebellar tonsil, foramen magnum, and dynamic flow of CSF at the craniocervical junction in AIS patients versus normal controls and their correlation with somatosensory cortical evoked potentials (SSEP). SUMMARY OF BACKGROUND DATA: Previous studies have documented obstructed CSF flow in patients with Chiari I malformation. Low-lying cerebellar tonsils and syringomyelia are also observed in AIS patients. We sought to investigate whether disturbed CSF flow is also evident in AIS subjects at the foramen magnum level and its association with level of cerebellar tonsils and dimensions of foramen magnum. METHODS: Conventional and phase-contrast MR were performed in 105 adolescent girls (69 AIS subjects and 36 age-matched controls). Measurements of cerebellar tonsillar level related to the basion-opsithion (BO) line, anteroposterior (AP), transverse (TS) diameter, and area of foramen magnum, and peak velocity of CSF flow in both the anterior and posterior subarachnoid space through foramen magnum were obtained. Correlations were made among different parameters and SSEP findings. RESULTS: A total of 42% of subjects in the AIS group had the cerebellar tonsillar tip positioned 1 mm below the BO line. The cerebellar tonsillar level in AIS subjects was significantly lower than the median tonsillar level in normal controls (P < 0.01). The AP diameter and area of foramen magnum were significantly larger in AIS subjects when compared with normal controls (P < 0.05), but the peak CSF velocities through foramen magnum showed no significant difference (P > 0.05). CONCLUSION: Peak CSF velocities through foramen magnum were not significantly different in AIS subjects despite the presence of low-lying cerebellar tonsils. This might be explained by the compensatory effect of larger foramen magnum in AIS subjects. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/17621216/A_detailed_morphologic_and_functional_magnetic_resonance_imaging_study_of_the_craniocervical_junction_in_adolescent_idiopathic_scoliosis_ L2 - https://doi.org/10.1097/BRS.0b013e318074d539 DB - PRIME DP - Unbound Medicine ER -