Dataset Information

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study.

ABSTRACT:

Objective

To investigate the cervical alignment and the relative range of motion (ROM) in patients with basilar invagination (BI).

Methods

A total of 40 BI cases (38.1 years old ± 17.9 years old, 19 male and 21 female) and 80 asymptomatic individuals (33.8 years old ± 10.8 years old, 40 male and 40 female) were included. The Skull-C₂ /Skull-BV, Skull-C₇ , C₂ -C₇ /BV-C₇ wall angles, C₀ -C₂ /C₀ -BV, C₀ -C₇ , C₁ -C₇ , and C₂ -C₇ /BV-C₇ angles were measured in dynamic X-ray images (including neutral, extension, and flexion positions). Correlation between the upper and lower cervical curvatures were analyzed. The total, extension, and flexion ROMs of these angles were calculated, respectively.

Results

The BI patients had a smaller C₀ -C₂ /C₀ -BV angle (18.2° ± 16.4° vs 30.9° ± 9.3°), but larger C₂ -C₇ /BV-C₇ (32.2° ± 16.1° vs 19.4° ± 10.6°) and C₂ -C₇ /BV-C₇ wall angles (37.8° ± 17.2° vs 23.6° ± 10.2°) than the control group in neutral position. The upper and lower curvatures correlated negatively in neutral (r = -0.371), extension (r = -0.429), and flexion (r = -0.648) positions among BI patients, as well as in extension position (r = -0.317) among control group. The BI patients presented smaller total ROMs in Skull-C₂ /Skull-BV (12.3° ± 16.6° vs 19.7° ± 10.9°), C₀ -C₂ /C₀ -BV (8.1° ± 11.1° vs 17.6° ± 10.5°), and C₀ -C₇ angles (57.8° ± 14.2° vs 78.3° ± 17.9°), but a larger total ROM in C₂ -C₇ /BV-C₇ wall angle (52.8° ± 13.9° vs 27.0° ± 16.1°) than the control group. The BI patients also presented smaller extension ROMs in Skull-C₂ /Skull-BV (6.9° ± 9.4° vs 12.5° ± 9.3°), Skull-C₇ (24.5° ± 10.9° vs 30.7° ± 12.5°), and C₀ -C₂ /C₀ -BV angles (4.4° ± 7.8° vs 9.9° ± 8.6°) than the control group. Moreover, the BI patients showed smaller absolute values of flexion ROMs in Skull-C₂ /Skull-BV (-5.2° ± 9.4° vs -7.3° ± 8.0°), C₀ -C₂ /C₀ -BV (-3.2° ± 8.8° vs -7.7° ± 8.7°), and C₀ -C₇ angles (-33.2° ± 13.0° vs -52.8° ± 19.2°), but a larger absolute value of flexion ROM in C₂ -C₇ /BV-C₇ wall angle (-33.9° ± 14.8° vs -8.2° ± 15.1°).

Conclusion

The cervical spine was stiffer in BI patients than the asymptomatic individuals, especially in the upper cervical curvature. The negative correlation between upper and lower cervical curvatures was more obvious in BI patients.

SUBMITTER: Lin JY

PROVIDER: S-EPMC8926990 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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Publications

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study.

Lin Jun-Yu JY Bao Ming-Gui MG Lin Shao-Yi SY Liu Jun-Hao JH Liu Qi Q Li Ruo-Yao RY Huang Zu-Cheng ZC Zhu Qing-An QA Zhang Zhong-Min ZM Ji Wei W

Orthopaedic surgery 20220213 3

<h4>Objective</h4>To investigate the cervical alignment and the relative range of motion (ROM) in patients with basilar invagination (BI).<h4>Methods</h4>A total of 40 BI cases (38.1 years old ± 17.9 years old, 19 male and 21 female) and 80 asymptomatic individuals (33.8 years old ± 10.8 years old, 40 male and 40 female) were included. The Skull-C<sub>2</sub> /Skull-BV, Skull-C<sub>7</sub> , C<sub>2</sub> -C<sub>7</sub> /BV-C<sub>7</sub> wall angles, C<sub>0</sub> -C<sub>2</sub> /C<sub>0</sub> - ...[more]

PMID: 35156312

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Project description:Fibrous dysplasia (FD) is a mosaic disorder of benign fibro-osseous lesions, which may be associated with extraskeletal features as part of McCune-Albright syndrome (MAS). Cranial base abnormalities, including Chiari I malformation (CM1), in which the cerebellum extends below the foramen magnum, and secondary basilar invagination (BI), in which the odontoid prolapses into the posterior cranial fossa, are potentially serious complications of metabolic bone disorders. The purpose of this study was to determine the prevalence, natural history, and risk factors for CM1 and BI in patients with FD/MAS, and to determine mechanisms of cranial base deformities. Clinical and radiographic data from subjects in an FD/MAS natural history study were evaluated and compared to normal controls. In 158 patients with craniofacial FD, 10 (6.3%) cases of CM1 and 12 (7.6%) cases of BI were diagnosed. No cranial base abnormalities were identified in 10 control subjects. Craniomorphometric and volumetric analyses identified cranial constriction and cranial settling as the primary mechanisms of cranial base abnormalities, whereas intracranial hypertension was a contributing factor in a minority of subjects. Longitudinal analyses found progression of odontoid position with age, but no progression of tonsillar position. No endocrinopathies were associated with CM1. MAS endocrinopathies associated with BI included hyperthyroidism (odds ratio [OR] 12.0; 95% confidence interval [CI], 2.9 to 55.6; p < 0.01), precocious puberty (OR 5.6; 95% CI, 1.2 to 26.0; p < 0.05), and hypophosphatemia (OR 7.7; 95% CI, 1.9 to 27.0; p < 0.01). Scoliosis was associated with both CM1 (OR 4.8; 95% CI, 1.1 to 22.8; p < 0.05) and BI (OR = infinity; 95% CI, 4.7 to infinity; p < 0.01). This study successfully characterized cranial base abnormalities in FD/MAS and the pathophysiological connection between them. These findings support routine screening for cranial base abnormalities in patients with craniofacial FD, as well as aggressive management of contributory risk factors. © 2018 American Society for Bone and Mineral Research.

Dataset Information

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study.

Objective

Methods

Results

Conclusion

Publications

Cervical Alignment of Patients with Basilar Invagination: A Radiological Study.

Similar Datasets

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