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Is curve direction correlated with the side of dominant displacement of cerebellar tonsil and syrinx deviation in thoracic scoliosis secondary to Chiari Malformation Type I and syringomyelia?
MedLine Citation:
PMID:  22744510     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
The patho-mechanism of scoliosis in patients with syringomyelia (SM) secondary to Chiari malformation type I (CMI) remains unknown up till now. In small sample studies published recently, there was an observation that curve direction tended to be on the same side as the dominant side of tonsillar displacement or the deviated side of syrinx location. Herein, a large-sample study of patients with single thoracic scoliosis secondary to CMI and SM was performed to validate these findings. The clinical and radiographic data of patients with scoliosis secondary to SM and CMI were reviewed. And patients who met the inclusion criteria were included. Based on the imaging presentation, the asymmetry of tonsillar displacement, syrinx location and scoliosis were judged by quantitative method. Then the imaging association among asymmetrically displaced tonsil, eccentrically located syrinx and curve direction were further analyzed. Thirty-nine patients with single thoracic scoliosis secondary to CMI and SM were included. 80% subjects showed concordance between the deviated side of eccentrically located syrinx and the dominant side of asymmetrically displaced tonsil. In 86% patients with asymmetrically displaced tonsil, thoracic curve was convex to the dominant side of tonsillar displacement. In 68% of patients with eccentrically located syrinx, the convex side of thoracic curve was on the same side as the deviated side of syrinx location. Asymmetrically displaced tonsils and eccentrically located syrinx are common imaging presentations in patients with SM secondary to CMI. The thoracic scoliosis in these patients was usually convex not only to the dominant side of asymmetrically displaced tonsils, but also to the side of eccentrically located syrinx, indicating that the asymmetry of tonsillar displacement and syrinx location might be involved in the regulation of curve direction.
Authors:
Tao Wu; Zezhang Zhu; Xu Sun; Huang Yan; Xin Zheng; Bangping Qian; Feng Zhu; Winnie Chu; Jack C Y Cheng; Yong Qiu
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Studies in health technology and informatics     Volume:  176     ISSN:  0926-9630     ISO Abbreviation:  Stud Health Technol Inform     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9214582     Medline TA:  Stud Health Technol Inform     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  286-90     Citation Subset:  T    
Affiliation:
Spine Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China.
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