Scoliotic Curve Patterns in Patients With Chiari I Malformation and/or Syringomyelia

Abstract

Although the decision to obtain magnetic resonance imaging in a patient with scoliosis should be based on both clinical and radiographic criteria, we suggest that a heightened index of suspicion is warranted with certain curve patterns (left thoracic, double thoracic, triple, and a long right thoracic curve with end vertebra caudal to T12), and with a high or low apex and/or end vertebra, especially in males and patients with a normal to hyperkyphotic thoracic spine.

Sagittal spinopelvic alignment in adolescent thoracic scoliosis secondary to Chiari I malformation: a comparison between the left and the right curves

“…In line with previously described methods [2,5,9,11,12], four spinal and three pelvic parameters were measured on long-cassette standing upright lateral radiographs: thoracic kyphosis (TK): the angle between the superior endplate of the T3 vertebra and the inferior endplate of the T12 vertebra; lumbar lordosis (LL): the angle between the superior endplate of the L1 vertebra and the superior endplate of the S1 [9]; thoracolumbar junctional kyphosis (TJK): the angle between the superior endplate of T10 and the inferior endplate of L2 [12]; sagittal vertical axis (SVA): the distance between the C7 plumb line (C7PL) and the posterosuperior corner of S1 [2]; pelvic incidence (PI): the angle between the line perpendicular to the sacral plate at its midpoint and the line connecting this point to the axis of the femoral heads; pelvic tilt (PT): the angle between the line connecting the midpoint of the sacral plate to the femoral head axis and the vertical axis; and sacral slope (SS): the angle between the superior plate of S1 and a horizontal line [11]. Figure 1 illustrates the method of identifying the axis of the femoral heads in pelvic measurement.…”

“…Recently, several studies revealed that the classic apical hypokyphosis, as have been invariably demonstrated in adolescent idiopathic thoracic scoliosis (AIS), was absent in most cases with Chiari malformationassociated scoliosis (CMS) [4][5][6][7]. To our knowledge, however, no published study has specifically addressed the morphological differences between CMS patients and healthy controls.…”

“…In addition, although the so-called ''atypical'' left thoracic curve pattern has a high frequency of occurrence in CMS [5,6,8], there is a paucity of literature focusing on the differences in sagittal profiles between the left and right thoracic curves. Extracted data from the study by Spiegel et al [5] manifested a trend that CMS patients with a left thoracic curve had larger thoracic kyphosis than those with a right thoracic curve.…”

“…Extracted data from the study by Spiegel et al [5] manifested a trend that CMS patients with a left thoracic curve had larger thoracic kyphosis than those with a right thoracic curve. It appears rather difficult, though, to drawn any firm conclusions according to this study, given their small sample size (18 cases) as well as the relatively wide age range (4.7-19.8 years).…”

Scoliotic curve patterns in patients with Marfan syndrome

“…''Typical'' versus ''atypical'' curve pattern In order to compare curve patterns in our scoliotic patients with idiopathic patterns, we used the concept developed by Spiegel et al [11], namely that of ''typical'' curve pattern, based on historic control. These authors assumed that ''atypical'' refers to patterns seen with a low frequency in the idiopathic population.…”