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Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study.
Eur Spine J. 2016 Feb; 25(2):619-26.ES

Abstract

PURPOSE

To describe curve patterns in patients with Chiari malformation I (CIM) without syringomyelia, and compare to patients with Chiari malformation with syringomyelia (CIM + SM).

METHODS

Review of medical records from 2000 to 2013 at a single institution was performed to identify CIM patients with scoliosis. Patients with CIM were matched (1:1) by age and gender to CIM + SM. Radiographic curve patterns, MRI-based craniovertebral junction parameters, and associated neurological signs were compared between the two cohorts.

RESULTS

Eighteen patients with CIM-associated scoliosis in the absence of syringomyelia were identified; 14 (78 %) were female, with mean age of 11.5 ± 4.5 years. Mean tonsillar descent was 9.9 ± 4.1 mm in the CIM group and 9.1 ± 3.0 mm in the CIM + SM group (p = 0.57). Average syrinx diameter in the CIM + SM group was 9.0 ± 2.7 mm. CIM patients demonstrated less severe scoliotic curves (32.1° vs. 46.1°, p = 0.04), despite comparable thoracic kyphosis (43.7° vs. 49.6°, p = 0.85). Two (11 %) patients with CIM demonstrated thoracic apex left deformities compared to 9/18 (50 %) in the CIM + SM cohort (p = 0.01). Neurological abnormalities were only observed in the group with syringomyelia (6/18, or 33 %; p = 0.007).

CONCLUSION

In the largest series specifically evaluating CIM and scoliosis, we found that these patients appear to present with fewer atypical curve features, with less severe scoliotic curves, fewer apex left curves, and fewer related neurological abnormalities than CIM + SM. Notably, equivalent thoracic kyphosis was observed in both groups. Future studies are needed to better understand pathogenesis of spinal deformity in CIM with and without SM.

Authors+Show Affiliations

Department of Neurosurgery, Barrow Neurological Institute, 350 W. Thomas Road, Phoenix, AZ, 85013, USA. jakub.godzik@bnaneuro.net.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA.Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA. Department of Pediatric Neurosurgery, St. Louis Children's Hospital, St. Louis, MO, USA.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA. Department of Pediatric Neurosurgery, St. Louis Children's Hospital, St. Louis, MO, USA.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA. Department of Pediatric Neurosurgery, St. Louis Children's Hospital, St. Louis, MO, USA.Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA. Department of Pediatric Neurosurgery, St. Louis Children's Hospital, St. Louis, MO, USA.

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25981206

Citation

Godzik, J, et al. "Comparison of Spinal Deformity in Children With Chiari I Malformation With and Without Syringomyelia: Matched Cohort Study." European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 25, no. 2, 2016, pp. 619-26.
Godzik J, Dardas A, Kelly MP, et al. Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study. Eur Spine J. 2016;25(2):619-26.
Godzik, J., Dardas, A., Kelly, M. P., Holekamp, T. F., Lenke, L. G., Smyth, M. D., Park, T. S., Leonard, J. R., & Limbrick, D. D. (2016). Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study. European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 25(2), 619-26. https://doi.org/10.1007/s00586-015-4011-1
Godzik J, et al. Comparison of Spinal Deformity in Children With Chiari I Malformation With and Without Syringomyelia: Matched Cohort Study. Eur Spine J. 2016;25(2):619-26. PubMed PMID: 25981206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of spinal deformity in children with Chiari I malformation with and without syringomyelia: matched cohort study. AU - Godzik,J, AU - Dardas,A, AU - Kelly,M P, AU - Holekamp,T F, AU - Lenke,L G, AU - Smyth,M D, AU - Park,T S, AU - Leonard,J R, AU - Limbrick,D D, Y1 - 2015/05/17/ PY - 2014/12/05/received PY - 2015/05/05/accepted PY - 2015/05/05/revised PY - 2015/5/19/entrez PY - 2015/5/20/pubmed PY - 2016/9/20/medline KW - Chiari malformation KW - Kyphosis KW - Scoliosis KW - Spinal deformity KW - Syringomyelia SP - 619 EP - 26 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 25 IS - 2 N2 - PURPOSE: To describe curve patterns in patients with Chiari malformation I (CIM) without syringomyelia, and compare to patients with Chiari malformation with syringomyelia (CIM + SM). METHODS: Review of medical records from 2000 to 2013 at a single institution was performed to identify CIM patients with scoliosis. Patients with CIM were matched (1:1) by age and gender to CIM + SM. Radiographic curve patterns, MRI-based craniovertebral junction parameters, and associated neurological signs were compared between the two cohorts. RESULTS: Eighteen patients with CIM-associated scoliosis in the absence of syringomyelia were identified; 14 (78 %) were female, with mean age of 11.5 ± 4.5 years. Mean tonsillar descent was 9.9 ± 4.1 mm in the CIM group and 9.1 ± 3.0 mm in the CIM + SM group (p = 0.57). Average syrinx diameter in the CIM + SM group was 9.0 ± 2.7 mm. CIM patients demonstrated less severe scoliotic curves (32.1° vs. 46.1°, p = 0.04), despite comparable thoracic kyphosis (43.7° vs. 49.6°, p = 0.85). Two (11 %) patients with CIM demonstrated thoracic apex left deformities compared to 9/18 (50 %) in the CIM + SM cohort (p = 0.01). Neurological abnormalities were only observed in the group with syringomyelia (6/18, or 33 %; p = 0.007). CONCLUSION: In the largest series specifically evaluating CIM and scoliosis, we found that these patients appear to present with fewer atypical curve features, with less severe scoliotic curves, fewer apex left curves, and fewer related neurological abnormalities than CIM + SM. Notably, equivalent thoracic kyphosis was observed in both groups. Future studies are needed to better understand pathogenesis of spinal deformity in CIM with and without SM. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/25981206/Comparison_of_spinal_deformity_in_children_with_Chiari_I_malformation_with_and_without_syringomyelia:_matched_cohort_study_ L2 - https://doi.org/10.1007/s00586-015-4011-1 DB - PRIME DP - Unbound Medicine ER -