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Basilar Invagination: A Craniocervical Kyphosis.
World Neurosurg. 2018 Sep; 117:e180-e186.WN

Abstract

BACKGROUND

For more than a century, odontoid process prolapse, which compresses cranial base structures, has been the hallmark of basilar invagination (BI). The angulation of the whole skull toward the cervical spine may be considered to contribute to BI and odontoid prolapse. The objective of this study was to evaluate the craniocervical angular craniometry of patients with BI compared with patients with Chiari malformation (CM) and normal subjects.

METHODS

Angular craniocervical relationships among midline magnetic resonance imaging scans from patients with BI, patients with CM, and normal subjects were evaluated and compared. Angles were measured by Meazure 2.0 software from digitalized images.

RESULTS

Using data from 121 images, 42 patients with BI (14 type I BI, 28 type II BI), 47 patients with CM, and 32 control subjects were evaluated. The BI group had a more acute kyphotic angle than the CM group (P < 0.01) and control group. The kyphosis difference was 17.57 ± 2.3° (P < 0.01) between the BI and CM groups and 21.19 ± 2.3° (P < 0.01) between the BI and control groups. Basal angles were significantly larger in the BI group compared with the other 2 groups. A strong correlation was found with kyphosis and CLV and the clivus-canal angle and cervical lordosis angle (P < 0.01).

CONCLUSIONS

Craniocervical kyphosis in patients with BI was approximately 20° greater than in normal subjects and patients with CM. Craniocervical kyphosis should be considered a pathophysiologic condition in BI.

Authors+Show Affiliations

Post-graduation Program, Hospital do Servidor Público Estadual, São Paulo, Brazil. Electronic address: bitbot@uol.com.br.Post-graduation Program, Hospital do Servidor Público Estadual, São Paulo, Brazil.Post-graduation Program, Hospital do Servidor Público Estadual, São Paulo, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29886302

Citation

Botelho, Ricardo Vieira, et al. "Basilar Invagination: a Craniocervical Kyphosis." World Neurosurgery, vol. 117, 2018, pp. e180-e186.
Botelho RV, Ferreira JA, Zandonadi Ferreira ED. Basilar Invagination: A Craniocervical Kyphosis. World Neurosurg. 2018;117:e180-e186.
Botelho, R. V., Ferreira, J. A., & Zandonadi Ferreira, E. D. (2018). Basilar Invagination: A Craniocervical Kyphosis. World Neurosurgery, 117, e180-e186. https://doi.org/10.1016/j.wneu.2018.05.233
Botelho RV, Ferreira JA, Zandonadi Ferreira ED. Basilar Invagination: a Craniocervical Kyphosis. World Neurosurg. 2018;117:e180-e186. PubMed PMID: 29886302.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Basilar Invagination: A Craniocervical Kyphosis. AU - Botelho,Ricardo Vieira, AU - Ferreira,Jânio Alves, AU - Zandonadi Ferreira,Edson Dener, Y1 - 2018/06/07/ PY - 2018/05/09/received PY - 2018/05/29/revised PY - 2018/05/30/accepted PY - 2018/6/11/pubmed PY - 2018/10/17/medline PY - 2018/6/11/entrez KW - Arnold-Chiari malformation KW - Basilar impression KW - Cephalometry KW - Pathophysiology KW - Platybasia SP - e180 EP - e186 JF - World neurosurgery JO - World Neurosurg VL - 117 N2 - BACKGROUND: For more than a century, odontoid process prolapse, which compresses cranial base structures, has been the hallmark of basilar invagination (BI). The angulation of the whole skull toward the cervical spine may be considered to contribute to BI and odontoid prolapse. The objective of this study was to evaluate the craniocervical angular craniometry of patients with BI compared with patients with Chiari malformation (CM) and normal subjects. METHODS: Angular craniocervical relationships among midline magnetic resonance imaging scans from patients with BI, patients with CM, and normal subjects were evaluated and compared. Angles were measured by Meazure 2.0 software from digitalized images. RESULTS: Using data from 121 images, 42 patients with BI (14 type I BI, 28 type II BI), 47 patients with CM, and 32 control subjects were evaluated. The BI group had a more acute kyphotic angle than the CM group (P < 0.01) and control group. The kyphosis difference was 17.57 ± 2.3° (P < 0.01) between the BI and CM groups and 21.19 ± 2.3° (P < 0.01) between the BI and control groups. Basal angles were significantly larger in the BI group compared with the other 2 groups. A strong correlation was found with kyphosis and CLV and the clivus-canal angle and cervical lordosis angle (P < 0.01). CONCLUSIONS: Craniocervical kyphosis in patients with BI was approximately 20° greater than in normal subjects and patients with CM. Craniocervical kyphosis should be considered a pathophysiologic condition in BI. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/29886302/Basilar_Invagination:_A_Craniocervical_Kyphosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(18)31187-2 DB - PRIME DP - Unbound Medicine ER -