Cervical spinal canal narrowing in idiopathic syringomyelia

Struck, Aaron F.; Carr, Carrie M.; Shah, Vinil; Hesselink, John R.; Haughton, Victor M.

doi:10.1007/s00234-016-1701-2

Cited by 8 publications

(13 citation statements)

References 18 publications

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“…7 In one study, 2 lower cervical spine diameters tapered more steeply in 50 patients with idiopathic syringomyelia than they did in control patients, as was the case in this study. 2 We found Chiari patients with syrinx had C1-C7 of À0.06 cm/level, in agreement with a previous study. 3 Our data on dural sac area tapering in controls agree well with those in previous studies of normal subjects.…”

Section: Discussionsupporting

confidence: 93%

Spinal subarachnoid space tapering in patients with syringomyelia

et al. 2019

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Background and purpose Cervical spine tapering affects cerebrospinal fluid dynamics. Cervical spine taper ratios derived from anteroposterior diameters reportedly differ between patients with syringomyelia and controls. We attempted to verify the differences in diameter and to show differences in cross-sectional area between syringomyelia and controls. Methods Cervical spine magnetic resonance images in syringomyelia patients (idiopathic or Chiari I related) and control patients were examined. In each subject, the anteroposterior diameter of the spinal canal was measured at each cervical level, and C1–C4, C4–C7, and C1–C7 taper ratios were calculated. Differences in taper ratio between groups were tested for statistical significance with the t-test. Cross-sectional areas of the spinal canal were measured at each cervical spinal level, and tapering was calculated. Results Eighteen patients with idiopathic syringomyelia, 28 with Chiari I, and 29 controls were studied. Chiari and syringomyelia patients had significantly steeper diameter-based taper ratios than controls. The dural sac areas tapered proportionally with the diameter-based taper ratio in all groups. Conclusions Cervical spine anteroposterior diameter tapering and dural sac cross-sectional areas tapering differ between syringomyelia patients and controls.

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Section: Discussionsupporting

confidence: 93%

Spinal subarachnoid space tapering in patients with syringomyelia

et al. 2019

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“…Taper ratios of the cervical spine have been measured in groups of Chiari I, idiopathic syringomyelia, and normal control individuals. 6,7,9–11 Normal controls in one study had an average C1 to C7 ratio of –0.3 mm/level, as they did in our study. 9 Chiari I cases in reported studies had C1 to C7 ratios of –0.4 to –0.6 mm/level or 0.3 to 0.7 mm/level, similar to our study.…”

Section: Discussionsupporting

confidence: 73%

“…6 Patients with idiopathic syringomyelia have greater reverse tapering of the lower cervical spine than do normal controls. 7 Reverse tapering causes an adverse pressure gradient (opposite of the direction of CSF flow), diminishes CSF flow velocities, and produces complex hydrodynamic and biomechanical effects. Some relationships of CSF flow and adverse pressure gradients have been studied.…”

Section: Introductionmentioning

confidence: 99%

Anatomical features of the cervical spinal canal in Chiari I deformity with presyrinx: A case-control study

et al. 2017

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Purpose The relationship between syringomyelia and presyrinx, characterized by edema in the spinal cord, has not been firmly established. Patients with syringomyelia have abnormal spinal canal tapering that alters cerebrospinal fluid flow dynamics, but taper ratios in presyrinx have never been reported. We tested the hypothesis that presyrinx patients have abnormal spinal canal tapering. Materials and methods At six medical institutions, investigators searched the PACS system for patients with Chiari I and spinal cord edema unassociated with tumor, trauma, or other evident cause. In each case taper ratios were calculated for C1 to C4 and C4 to C7. In two age- and gender-matched control groups, Chiari I patients with no syringomyelia and patients with normal MR scans, the same measurements were made. Differences between groups were tested for statistical significance with t tests. Results The study enrolled 21 presyrinx patients and equal numbers of matched Chiari I and normal controls. C4 to C7 taper ratios were positive and steeper in presyrinx patients than in the normal controls ( p = 0.04). The upper cervical spine, C1 to C4, tapered negatively in cases and controls without significant differences between the groups. The difference in degree of tonsillar herniation was statistically significant between presyrinx patients and Chiari I controls ( p = 0.01). Conclusions Presyrinx patients have greater than normal positive tapering in the lower cervical spine and greater degree of tonsillar herniation than the controls.

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“…17 Patients with idiopathic syringomyelia had steeper than normal positive tapering between C3 and C7. 18 Our study has limitations. We cannot exclude a bias due to our selection of patients with normal MR studies rather than healthy volunteers.…”

Section: Discussionmentioning

confidence: 89%

“…Age and gender are not significant variables for the tolerance limits. 4 22 with scoliosis with Chiari À2.2 No data À0.8 Hammersley et al 4 32 with scoliosis without Chiari À1.1 No data À0.4 Thompson et al 5 49 with Chiari with syrinx À1.22 0.28 À0.35 Thompson et al 5 101 with Chiari without syrinx À1.34 0.11 À0.5 Struck et al 18 50 with idiopathic syrinx À0.98 0.21 À0.30 Zhu et al 6 44 with Chiari with distended syrinx À0.98 0.24 À0.34 Zhu et al 6 33 with Chiari with non-distended syrinx -…”

Section: Resultsmentioning

confidence: 99%

Cervical spine taper ratios: Normal tolerance limits

2018

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Background Spinal canal tapering, which can be measured as taper ratios, affects cerebrospinal fluid flow dynamics. We calculated the tolerance interval for normal cervical spine taper ratios to facilitate the detection of abnormal taper ratios. Methods We collected a series of patients who had cervical spine magnetic resonance studies reported as normal. We measured anteroposterior diameters of the cervical spine and calculated C1-C4, C4-C7, and C1-C7 taper by standard methodology. We calculated the normal tolerance limits for taper ratios and compared results of this study with data in previous reports on taper ratios. Results We enrolled 78 patients aged 2-55 years. The 99% tolerance limits for the taper ratios for C1-C4, C4-C7, and C1-C7 were -0.31 to +0.09, -0.11 to +0.14, and -0.13 to +0.05 cm/level, respectively. Age and sex were not significant variables for taper ratios. Taper ratios in this study agreed with those reported for controls in previous studies. Patients with syringomyelia in previous reports tended to have taper ratios outside the normal tolerance limits. Conclusion Normal limits of the cervical taper ratios are reported.

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Cervical spinal canal narrowing in idiopathic syringomyelia

Abstract: Patients with IS have abnormally narrow upper and mid cervical spinal canal diameters and greater positive tapering between C3 and C7.

Cited by 8 publications

References 18 publications

Spinal subarachnoid space tapering in patients with syringomyelia

Spinal subarachnoid space tapering in patients with syringomyelia

Anatomical features of the cervical spinal canal in Chiari I deformity with presyrinx: A case-control study

Cervical spine taper ratios: Normal tolerance limits

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