Radiological and clinical predictors of scoliosis in patients with Chiari malformation type I and spinal cord syrinx from the Park-Reeves Syringomyelia Research Consortium.

Autor:	Strahle JM; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Taiwo R; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Averill C; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Torner J; 2Department of Epidemiology, University of Iowa, Iowa City, Iowa., Shannon CN; 3Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Bonfield CM; 3Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Tuite GF; 4Department of Neurosurgery, Neuroscience Institute, All Children's Hospital, St. Petersburg, Florida., Bethel-Anderson T; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Rutlin J; 5Department of Radiology, Washington University School of Medicine, St. Louis, Missouri., Brockmeyer DL; 6Department of Pediatric Neurosurgery, University of Utah School of Medicine, Salt Lake City, Utah., Wellons JC; 3Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee., Leonard JR; 7Department of Neurological Surgery, The Ohio State University College of Medicine, Columbus, Ohio., Mangano FT; 8Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Johnston JM; 9Division of Neurosurgery, University of Alabama School of Medicine, Birmingham, Alabama., Shah MN; 10Department of Pediatric Surgery and Neurosurgery, The University of Texas McGovern Medical School, Houston, Texas., Iskandar BJ; 11Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin., Tyler-Kabara EC; 12Department of Neurosurgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania., Daniels DJ; 13Department of Neurosurgery, The Mayo Clinic, Rochester, Minnesota., Jackson EM; 14Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland., Grant GA; 15Department of Neurosurgery, Stanford Child Health Research Institute, Stanford, California., Couture DE; 16Department of Neurosurgery, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina., Adelson PD; 17Department of Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona., Alden TD; 18Department of Pediatric Neurosurgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois., Aldana PR; 19Department of Pediatric Neurosurgery, University of Florida College of Medicine, Jacksonville, Florida., Anderson RCE; 20Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York., Selden NR; 21Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon., Baird LC; 21Department of Neurological Surgery, Oregon Health & Science University, Portland, Oregon., Bierbrauer K; 8Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio., Chern JJ; 22Department of Neurosurgery, Children's Healthcare of Atlanta, Georgia., Whitehead WE; 23Department of Neurosurgery, Baylor College of Medicine, Houston, Texas., Ellenbogen RG; 24Department of Neurosurgery, University of Washington Medicine, Seattle, Washington., Fuchs HE; 25Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina., Guillaume DJ; 26Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, Minnesota., Hankinson TC; 27Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado., Iantosca MR; 28Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania., Oakes WJ; 9Division of Neurosurgery, University of Alabama School of Medicine, Birmingham, Alabama., Keating RF; 29Department of Neurosurgery, Children's National Medical Center, Washington, DC., Khan NR; 30Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee., Muhlbauer MS; 30Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee., McComb JG; 31Division of Neurosurgery, Children's Hospital Los Angeles, California., Menezes AH; 32Department of Neurosurgery, University of Iowa Hospitals, Iowa City, Iowa., Ragheb J; 33Department of Pediatric Neurosurgery, Miami Children's Hospital and University of Miami Miller School of Medicine, Miami, Florida., Smith JL; 34Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana., Maher CO; 35Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan., Greene S; 12Department of Neurosurgery, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania., Kelly M; 36Department of Orthopedic Surgery, Washington University School of Medicine, St. Louis, Missouri., O'Neill BR; 27Department of Neurosurgery, Children's Hospital Colorado, Aurora, Colorado., Krieger MD; 31Division of Neurosurgery, Children's Hospital Los Angeles, California., Tamber M; 37Department of Neurosurgery, The University of British Columbia, Vancouver, British Columbia, Canada., Durham SR; 38Department of Neurosurgery, University of Vermont College of Medicine, Burlington, Vermont., Olavarria G; 39Arnold Palmer Hospital for Children, Orlando, Florida., Stone SSD; 40Department of Neurosurgery, Boston Children's Hospital, Boston, Massachusetts., Kaufman BA; 41Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin., Heuer GG; 42Division of Neurosurgery, Children's Hospital of Philadelphia, Pennsylvania., Bauer DF; 43Department of Neurosurgery, Dartmouth Geisel School of Medicine, Hanover, New Hampshire., Albert G; 44Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas., Greenfield JP; 45Department of Neurological Surgery, Weill Cornell Medical Center, New York, New York., Wait SD; 46Department of Neurological Surgery, Levine Children's Hospital, Charlotte, North Carolina., Van Poppel MD; 46Department of Neurological Surgery, Levine Children's Hospital, Charlotte, North Carolina., Eskandari R; 47Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina; and., Mapstone T; 48Department of Neurosurgery, Oklahoma University Medical Center, Oklahoma City, Oklahoma., Shimony JS; 5Department of Radiology, Washington University School of Medicine, St. Louis, Missouri., Dacey RG; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Smyth MD; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Park TS; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri., Limbrick DD; 1Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery. Pediatrics [J Neurosurg Pediatr] 2019 Aug 16; Vol. 24 (5), pp. 520-527. Date of Electronic Publication: 2019 Aug 16 (Print Publication: 2019).
DOI:	10.3171/2019.5.PEDS18527
Abstrakt:	Objective: Scoliosis is frequently a presenting sign of Chiari malformation type I (CM-I) with syrinx. The authors' goal was to define scoliosis in this population and describe how radiological characteristics of CM-I and syrinx relate to the presence and severity of scoliosis. Methods: A large multicenter retrospective and prospective registry of pediatric patients with CM-I (tonsils ≥ 5 mm below the foramen magnum) and syrinx (≥ 3 mm in axial width) was reviewed for clinical and radiological characteristics of CM-I, syrinx, and scoliosis (coronal curve ≥ 10°). Results: Based on available imaging of patients with CM-I and syrinx, 260 of 825 patients (31%) had a clear diagnosis of scoliosis based on radiographs or coronal MRI. Forty-nine patients (5.9%) did not have scoliosis, and in 516 (63%) patients, a clear determination of the presence or absence of scoliosis could not be made. Comparison of patients with and those without a definite scoliosis diagnosis indicated that scoliosis was associated with wider syrinxes (8.7 vs 6.3 mm, OR 1.25, p < 0.001), longer syrinxes (10.3 vs 6.2 levels, OR 1.18, p < 0.001), syrinxes with their rostral extent located in the cervical spine (94% vs 80%, OR 3.91, p = 0.001), and holocord syrinxes (50% vs 16%, OR 5.61, p < 0.001). Multivariable regression analysis revealed syrinx length and the presence of holocord syrinx to be independent predictors of scoliosis in this patient cohort. Scoliosis was not associated with sex, age at CM-I diagnosis, tonsil position, pB-C2 distance (measured perpendicular distance from the ventral dura to a line drawn from the basion to the posterior-inferior aspect of C2), clivoaxial angle, or frontal-occipital horn ratio. Average curve magnitude was 29.9°, and 37.7% of patients had a left thoracic curve. Older age at CM-I or syrinx diagnosis (p < 0.0001) was associated with greater curve magnitude whereas there was no association between syrinx dimensions and curve magnitude. Conclusions: Syrinx characteristics, but not tonsil position, were related to the presence of scoliosis in patients with CM-I, and there was an independent association of syrinx length and holocord syrinx with scoliosis. Further study is needed to evaluate the nature of the relationship between syrinx and scoliosis in patients with CM-I.
Databáze:	MEDLINE
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