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Odontoid process inclination in normal adults and in an adult population with Chiari malformation Type I.
J Neurosurg Spine. 2015 Dec; 23(6):701-6.JN

Abstract

OBJECT

Posterior odontoid process inclination has been demonstrated as a factor associated with Chiari malformation Type I (CM-I) in the pediatric population; however, no studies to date have examined this measurement in the adult CM-I population. The purpose of this study was to evaluate craniocervical junction (CCJ) measurements in adult CM-I versus a control group.

METHODS

The odontoid retroflexion, odontoid retroversion, odontoid height, posterior basion to C-2 line measured to the dural margin (pB-C2 line), posterior basion to C-2 line measured to the dorsal odontoid cortical margin (pB-C2* line), and clivus-canal angle measurements were retrospectively analyzed in adult patients with CM-I using MRI. These measurements were compared with normative values established from CT scans of the cervical spine in adults without CM-I.

RESULTS

A statistically significant difference was found between 55 adults with CM-I and 150 sex-matched controls (125 used for analysis) in the mean clivus-canal angle and the mean pB-C2 line.

CONCLUSIONS

These data suggest that there are sex-specific differences with respect to measurements at the CCJ between men and women, with women showing a more posteriorly inclined odontoid process. There were also differences between the CM-I and control groups: a more acute clivus-canal angle was associated with CM-I in the adult population. These CCJ findings could have an influence on presurgical planning.

Authors+Show Affiliations

Department of Radiology, University of Utah, Salt Lake City, Utah; US Naval Medical Center Portsmouth, Virginia;Royal Perth Hospital, Perth; and. Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.Department of Radiology, University of Utah, Salt Lake City, Utah;

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26315958

Citation

Besachio, David A., et al. "Odontoid Process Inclination in Normal Adults and in an Adult Population With Chiari Malformation Type I." Journal of Neurosurgery. Spine, vol. 23, no. 6, 2015, pp. 701-6.
Besachio DA, Khaleel Z, Shah LM. Odontoid process inclination in normal adults and in an adult population with Chiari malformation Type I. J Neurosurg Spine. 2015;23(6):701-6.
Besachio, D. A., Khaleel, Z., & Shah, L. M. (2015). Odontoid process inclination in normal adults and in an adult population with Chiari malformation Type I. Journal of Neurosurgery. Spine, 23(6), 701-6. https://doi.org/10.3171/2015.3.SPINE14926
Besachio DA, Khaleel Z, Shah LM. Odontoid Process Inclination in Normal Adults and in an Adult Population With Chiari Malformation Type I. J Neurosurg Spine. 2015;23(6):701-6. PubMed PMID: 26315958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Odontoid process inclination in normal adults and in an adult population with Chiari malformation Type I. AU - Besachio,David A, AU - Khaleel,Ziyad, AU - Shah,Lubdha M, Y1 - 2015/08/28/ PY - 2015/8/29/entrez PY - 2015/9/1/pubmed PY - 2016/4/8/medline KW - CCJ = craniocervical junction KW - CM = Chiari malformation KW - CM-I = CM Type I KW - Chiari malformation KW - ICC = intraclass correlation coefficient KW - cervical KW - complex Chiari malformation KW - craniocervical junction KW - odontoid inclination KW - pB-C2 = a line drawn through the odontoid tip from the ventral dura perpendicular to a second line from the basion to the inferoposterior aspect of the C-2 vertebral body KW - pB-C2* = a line drawn through the odontoid tip from the posterior odontoid cortex perpendicular to a second line from the basion to the inferoposterior aspect of the C-2 vertebral body SP - 701 EP - 6 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 23 IS - 6 N2 - OBJECT: Posterior odontoid process inclination has been demonstrated as a factor associated with Chiari malformation Type I (CM-I) in the pediatric population; however, no studies to date have examined this measurement in the adult CM-I population. The purpose of this study was to evaluate craniocervical junction (CCJ) measurements in adult CM-I versus a control group. METHODS: The odontoid retroflexion, odontoid retroversion, odontoid height, posterior basion to C-2 line measured to the dural margin (pB-C2 line), posterior basion to C-2 line measured to the dorsal odontoid cortical margin (pB-C2* line), and clivus-canal angle measurements were retrospectively analyzed in adult patients with CM-I using MRI. These measurements were compared with normative values established from CT scans of the cervical spine in adults without CM-I. RESULTS: A statistically significant difference was found between 55 adults with CM-I and 150 sex-matched controls (125 used for analysis) in the mean clivus-canal angle and the mean pB-C2 line. CONCLUSIONS: These data suggest that there are sex-specific differences with respect to measurements at the CCJ between men and women, with women showing a more posteriorly inclined odontoid process. There were also differences between the CM-I and control groups: a more acute clivus-canal angle was associated with CM-I in the adult population. These CCJ findings could have an influence on presurgical planning. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/26315958/Odontoid_process_inclination_in_normal_adults_and_in_an_adult_population_with_Chiari_malformation_Type_I_ L2 - https://thejns.org/doi/10.3171/2015.3.SPINE14926 DB - PRIME DP - Unbound Medicine ER -