Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy
Objective Diseases of the craniovertebral junction (CVJ) are commonly associated with deformity, malalignment, and subsequent myelopathy. The misaligned CVJ might cause compression of neuronal tissues and subsequently clinical symptoms. The triangular area (TA), measured by magnetic resonance imagin...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spinal Neurosurgery Society
2022-12-01
|
| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2244786-393.pdf |
| _version_ | 1797329380078256128 |
|---|---|
| author | Chih-Chang Chang Jau-Ching Wu Chin-Chu Ko Hsuan-Kan Chang Yi-Hsuan Kuo Chao-Hung Kuo Tsung-Hsi Tu Wen-Cheng Huang |
| author_facet | Chih-Chang Chang Jau-Ching Wu Chin-Chu Ko Hsuan-Kan Chang Yi-Hsuan Kuo Chao-Hung Kuo Tsung-Hsi Tu Wen-Cheng Huang |
| author_sort | Chih-Chang Chang |
| collection | DOAJ |
| description | Objective Diseases of the craniovertebral junction (CVJ) are commonly associated with deformity, malalignment, and subsequent myelopathy. The misaligned CVJ might cause compression of neuronal tissues and subsequently clinical symptoms. The triangular area (TA), measured by magnetic resonance imaging/images (MRI/s), is a novel measurement for quantification of the severity of compression to the brain stem. This study aimed to assess the normal and pathological values of TA by a comparison of patients with CVJ disease to age- and sex-matched controls. Moreover, postoperative TAs were correlated with outcomes. Methods Consecutive patients who underwent surgery for CVJ disease were included for comparison to an age- and sex-matched cohort of normal CVJ persons as controls. The demographics, perioperative information, and pre- and postoperative 2-year cervical MRIs were collected for analysis. Cervical TAs were measured and compared. Results A total of 201 patients, all of whom had pre- or postoperative MRI, were analyzed. The TA of the CVJ deformity group was larger than the healthy control group (1.62 ± 0.57 cm2 vs. 1.01 ± 0.18 cm2, p < 0.001). Moreover, patients who had combined anterior odontoidectomy and posterior laminectomy with fixation had the greatest reduction in the TA (1.18 ± 0.58 cm2). Conclusion In CVJ deformity, the measurement of the cervical TA could indicate the severity of brain stem compression. After surgery, the TA had a varying degree of improvement, which could represent the efficacy of surgery. |
| first_indexed | 2024-03-08T07:04:51Z |
| format | Article |
| id | doaj.art-8cf7843b0a704a45af4dc6f3ca4d77e8 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T07:04:51Z |
| publishDate | 2022-12-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-8cf7843b0a704a45af4dc6f3ca4d77e82024-02-03T04:59:48ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912022-12-0119488989510.14245/ns.2244786.3931326Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and MyelopathyChih-Chang Chang0Jau-Ching Wu1Chin-Chu Ko2Hsuan-Kan Chang3Yi-Hsuan Kuo4Chao-Hung Kuo5Tsung-Hsi Tu6Wen-Cheng Huang7 Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, TaiwanObjective Diseases of the craniovertebral junction (CVJ) are commonly associated with deformity, malalignment, and subsequent myelopathy. The misaligned CVJ might cause compression of neuronal tissues and subsequently clinical symptoms. The triangular area (TA), measured by magnetic resonance imaging/images (MRI/s), is a novel measurement for quantification of the severity of compression to the brain stem. This study aimed to assess the normal and pathological values of TA by a comparison of patients with CVJ disease to age- and sex-matched controls. Moreover, postoperative TAs were correlated with outcomes. Methods Consecutive patients who underwent surgery for CVJ disease were included for comparison to an age- and sex-matched cohort of normal CVJ persons as controls. The demographics, perioperative information, and pre- and postoperative 2-year cervical MRIs were collected for analysis. Cervical TAs were measured and compared. Results A total of 201 patients, all of whom had pre- or postoperative MRI, were analyzed. The TA of the CVJ deformity group was larger than the healthy control group (1.62 ± 0.57 cm2 vs. 1.01 ± 0.18 cm2, p < 0.001). Moreover, patients who had combined anterior odontoidectomy and posterior laminectomy with fixation had the greatest reduction in the TA (1.18 ± 0.58 cm2). Conclusion In CVJ deformity, the measurement of the cervical TA could indicate the severity of brain stem compression. After surgery, the TA had a varying degree of improvement, which could represent the efficacy of surgery.http://e-neurospine.org/upload/pdf/ns-2244786-393.pdfcraniovertebral junction deformityatlantoaxial instabilitybasilar invaginationodontoid fracture |
| spellingShingle | Chih-Chang Chang Jau-Ching Wu Chin-Chu Ko Hsuan-Kan Chang Yi-Hsuan Kuo Chao-Hung Kuo Tsung-Hsi Tu Wen-Cheng Huang Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy Neurospine craniovertebral junction deformity atlantoaxial instability basilar invagination odontoid fracture |
| title | Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy |
| title_full | Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy |
| title_fullStr | Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy |
| title_full_unstemmed | Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy |
| title_short | Measurement of Deformity at the Craniovertebral Junction: Correlation of Triangular Area and Myelopathy |
| title_sort | measurement of deformity at the craniovertebral junction correlation of triangular area and myelopathy |
| topic | craniovertebral junction deformity atlantoaxial instability basilar invagination odontoid fracture |
| url | http://e-neurospine.org/upload/pdf/ns-2244786-393.pdf |
| work_keys_str_mv | AT chihchangchang measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT jauchingwu measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT chinchuko measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT hsuankanchang measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT yihsuankuo measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT chaohungkuo measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT tsunghsitu measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy AT wenchenghuang measurementofdeformityatthecraniovertebraljunctioncorrelationoftriangularareaandmyelopathy |