Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia

David A. Spiegel, John M. Flynn, Peter J. Stasikelis, John P. Dormans, Denis S. Drummond, Keith R. Gabriel, Randall Loder

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Study Design. A retrospective radiographic review was performed on 41 patients with scoliosis associated with a Chiari I malformation and/or syringomyelia. Objectives. To characterize curve patterns and curve features in this population and possibly refine the radiographic indications for magnetic resonance imaging in patients with a normal history and physical examination. Summary of Background Data. A subset of patients with "idiopathic" scoliosis may have an underlying neurologic abnormality. The radiographic indications for magnetic resonance imaging in asymptomatic patients with a normal clinical examination are not well defined. Methods. Data were collected from standing posteroanterior and lateral radiographs. The curve pattern and specific curve features were recorded and compared with historic controls. Thoracic kyphosis and total lumbar lordosis were also measured. Results. Fifty-one percent of patients were male. Ten curve patterns were identified, and, based on our criteria, approximately 50% of patients had an "atypical" pattern (left thoracic, double thoracic, triple, long right thoracic). A subset of those with "typical" patterns (right thoracic, right thoracic/left lumbar) had atypical features including a superior or inferior shift of the apex and/or the upper or lower end vertebrae. The mean kyphosis (T3-T12) was 41.8°. Conclusions. 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.

Original languageEnglish
Pages (from-to)2139-2146
Number of pages8
JournalSpine
Volume28
Issue number18
DOIs
StatePublished - Sep 15 2003

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Syringomyelia
Thorax
Scoliosis
Spine
Kyphosis
Magnetic Resonance Imaging
Nervous System Malformations
Lordosis
Physical Examination
History

Keywords

  • Chiari malformation
  • Curve pattern
  • Scoliosis
  • Syringomyelia

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Spiegel, D. A., Flynn, J. M., Stasikelis, P. J., Dormans, J. P., Drummond, D. S., Gabriel, K. R., & Loder, R. (2003). Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia. Spine, 28(18), 2139-2146. https://doi.org/10.1097/01.BRS.0000084642.35146.EC

Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia. / Spiegel, David A.; Flynn, John M.; Stasikelis, Peter J.; Dormans, John P.; Drummond, Denis S.; Gabriel, Keith R.; Loder, Randall.

In: Spine, Vol. 28, No. 18, 15.09.2003, p. 2139-2146.

Research output: Contribution to journalArticle

Spiegel, DA, Flynn, JM, Stasikelis, PJ, Dormans, JP, Drummond, DS, Gabriel, KR & Loder, R 2003, 'Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia', Spine, vol. 28, no. 18, pp. 2139-2146. https://doi.org/10.1097/01.BRS.0000084642.35146.EC
Spiegel DA, Flynn JM, Stasikelis PJ, Dormans JP, Drummond DS, Gabriel KR et al. Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia. Spine. 2003 Sep 15;28(18):2139-2146. https://doi.org/10.1097/01.BRS.0000084642.35146.EC
Spiegel, David A. ; Flynn, John M. ; Stasikelis, Peter J. ; Dormans, John P. ; Drummond, Denis S. ; Gabriel, Keith R. ; Loder, Randall. / Scoliotic curve patterns in patients with Chiari I malformation and/or syringomyelia. In: Spine. 2003 ; Vol. 28, No. 18. pp. 2139-2146.
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N2 - Study Design. A retrospective radiographic review was performed on 41 patients with scoliosis associated with a Chiari I malformation and/or syringomyelia. Objectives. To characterize curve patterns and curve features in this population and possibly refine the radiographic indications for magnetic resonance imaging in patients with a normal history and physical examination. Summary of Background Data. A subset of patients with "idiopathic" scoliosis may have an underlying neurologic abnormality. The radiographic indications for magnetic resonance imaging in asymptomatic patients with a normal clinical examination are not well defined. Methods. Data were collected from standing posteroanterior and lateral radiographs. The curve pattern and specific curve features were recorded and compared with historic controls. Thoracic kyphosis and total lumbar lordosis were also measured. Results. Fifty-one percent of patients were male. Ten curve patterns were identified, and, based on our criteria, approximately 50% of patients had an "atypical" pattern (left thoracic, double thoracic, triple, long right thoracic). A subset of those with "typical" patterns (right thoracic, right thoracic/left lumbar) had atypical features including a superior or inferior shift of the apex and/or the upper or lower end vertebrae. The mean kyphosis (T3-T12) was 41.8°. Conclusions. 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.

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