Exploring the Pathogenesis of Atlanto-Occipital Instability in Chiari Malformation With Type II Basilar Invagination: A Systematic Morphological Study.
Exploring the Pathogenesis of Atlanto-Occipital Instability in Chiari Malformation With Type II Basilar Invagination: A Systematic Morphological Study.
复制标题
DOI：
10.1227/neu.0000000000002284
复制
发表时间：
2023-04-01
期刊：
影响因子：
4.8
通讯作者：
中科院分区：
文献类型：
--
作者：
Our previous study suggested that atlanto-occipital instability (AOI) is common in patients with type II basilar invagination (II-BI). To further understand the pathogenesis of AOI in Chiari malformations (CM) and CM + II-BI through systematic measurements of the bone structure surrounding the craniocervical junction. Computed tomography data from 185 adults (80 controls, 63 CM, and 42 CM + II-BI) were collected, and geometric models were established for parameter measurement. Canonical correlation analysis was used to evaluate the morphological and positional relationships of the atlanto-occipital joint (AOJ). Among the 3 groups, the length and height of the condyle and superior portion of the lateral masses of the atlas (C1-LM) were smallest in CM + II-BI cases; the AOJ had the shallowest depth and the lowest curvature in the same group. AOJs were divided into 3 morphological types: type I, the typical ball-and-socket joint, mainly in the control group (100%); type II, the shallower joint, mainly in the CM group (92.9%); and type III, the abnormal flat-tilt joint, mainly in the CM + II-BI group (89.3%). Kinematic computed tomography revealed AOI in all III-AOJs (100%) and some II-AOJs (1.5%) but not in type I-AOJs (0%). Morphological parameters of the superior portion of C1-LM positively correlated with those of C0 and the clivus and significantly correlated with AOI. Dysplasia of the condyle and superior portion of C1-LM exists in both CM and II-BI cases yet is more obvious in type II-BI. Unstable movement caused by AOJ deformation is another pathogenic factor in patients with CM + II-BI.
登录
查看更多内容
影响因子：
2
作者：
Botelho, Ricardo Vieira;Ferreira, Janio Alves;Zandonadi Ferreira, Edson Dener
通讯作者：
Zandonadi Ferreira, Edson Dener
影响因子：
2
作者：
Xia, Zhi-Yuan;Duan, Wan-Ru;Chen, Zan
通讯作者：
Chen, Zan
影响因子：
2.8
作者：
Frankel, Bruce M.;Hanley, Michael;Rumboldt, Zoran
通讯作者：
Rumboldt, Zoran
影响因子：
5.3
作者：
Astur, Nelson;Klimo, Paul, Jr.;Warner, William C., Jr.
通讯作者：
Warner, William C., Jr.
影响因子：
2
作者：
Zhou, Qiang;Song, Chong;Lu, Yuntao
通讯作者：
Lu, Yuntao