Radiological Evaluation of Craniocervical Region in Patients with Basilar Invagination.

Abstract:

STUDY DESIGN:A retrospective analysis of collected data. OBJECTIVE:Our study aims to present the morphology of cranial-cervical spinal canal in basilar invagination (BI) patients. SUMMARY OF BACKGROUND DATA:BI is characterized by protrusion of the odontoid process into the foramen magnum (C0), leading to compression of the cervicomedullary junction. However, no study has ever clarified the anatomical diameters of spinal canal in patients with BI. METHODS:The study retrospectively examined computed tomography (CT)-based anatomical characteristics in a cohort of 84 patients with and without BI. We measured the anteroposterior diameter (APD) and transversal diameter (TVD) of spinal canal from C0 to C4, together with the area of vertebral canal (Area). Independent samples t test was used for statistical analysis. RESULTS:The APD in the BI group was shorter than the control group from C0 to C2 (C0: 27.98 vs. 35.11 mm, P < 0.001; C1: 11.87 vs. 16.91 mm, P < 0.001; C2: 12.91 vs. 14.84 mm, P < 0.001), but it became longer from C3 to C4. The TVD of the BI group was significantly wider from C0 to C3 (C0: 30.59 vs. 28.54 mm, P < 0.001; C1: 31.31 vs. 25.98 mm, P < 0.001; C2: 21.56 vs. 20.40 mm, P = 0.01; C3: 22.45 vs. 21.23 mm, P = 0.013), and it had no significance at C4. The Area showed no difference between the two groups from C1 to C2, but it turned larger at C3 and C4 in BI patients. CONCLUSION:BI patients may have shorter APD from C0 to C2, which could be the leading cause of neurological compression, necessitating decompression on sagittal plane. Below the pathological levels, BI patients have larger spinal canal than general population. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Ji W,Xu X,Wu Z,Liu X,Kong G,Huang Z,Chen J

doi

10.1097/BRS.0000000000002706

subject

Has Abstract

pub_date

2018-11-15 00:00:00

pages

E1305-E1312

issue

22

eissn

0362-2436

issn

1528-1159

pii

00007632-201811150-00005

journal_volume

43

pub_type

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