Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis

Objective:  To evaluate variations in cerebellar tonsil position after posterior spinal fusion (PSF) in neurologically intact patients with adolescent idiopathic scoliosis (AIS).  Methods: We retrospective evaluated 40 patients with AIS and no neurological symptoms that underwent PSF. Anteroposteri...

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Main Authors: Santiago Tomas Bosio, Miguel Puigdevall, Jorge Hokama, Ruben Maenza
Format: Article
Language:English
Published: Asociación Argentina de Ortopedia y Traumatología 2016-02-01
Series:Revista de la Asociación Argentina de Ortopedia y Traumatología
Subjects:
Online Access:http://ojs.aaot.org.ar/ojsr/index.php/AAOTMAG/article/view/504
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author Santiago Tomas Bosio
Miguel Puigdevall
Jorge Hokama
Ruben Maenza
author_facet Santiago Tomas Bosio
Miguel Puigdevall
Jorge Hokama
Ruben Maenza
author_sort Santiago Tomas Bosio
collection DOAJ
description Objective:  To evaluate variations in cerebellar tonsil position after posterior spinal fusion (PSF) in neurologically intact patients with adolescent idiopathic scoliosis (AIS).  Methods: We retrospective evaluated 40 patients with AIS and no neurological symptoms that underwent PSF. Anteroposterior and sagittal standing radiographs, and sagittal hindbrain MRI were performed in all patients before and after spinal surgery.  The level of the cerebellar tonsil relative to the magnum foramen was measured according to the method described by Aboulezz (J Comput Assist Tomogr 1985). We evaluate variations in cerebellar tonsil position in relation to spinal correction and spinal elongation after PSF. Results: Mean preoperative magnitude of the curve was 53,15° (SD 10,46°) and thoracic kyphosis was 35,42º (SD 12,38°). Mean postoperative values were 7,45º (SD 7,33°)  and 27,87º (SD 9,03°), respectively. This represents 86% correction in the coronal plane (p<0.00001) and 25% of kyphosis variation (p<0.00001). The average length of the spine in the coronal plane was 44,5 cm (SD 5,25 cm) in preoperative x-rays and 48,27 cm (SD 4,40 cm) in postoperative x-rays (p<0.00001).  The average length in the sagittal plane was 50,87 cm (SD 4,47 cm) in preoperative x-rays and 55,13cm (SD 3,27 cm) in postoperative x-rays (p<0.00001). There was no significant difference in the position of the Cerebellar Tonsil before and after spinal correction (p=0,6042). In 10 (25%) of the 40 patients, we observed caudal displacement in cerebellar tonsil position after PSF. Average displacement in these patients was 1,22 mm (range 0.1-2.3 mm). In 21 patients we did not observe any variation and in 2 a cephalic displacement was measured. Conclusions:  In most AIS patients, position of the cerebellar tonsil does not change with PSF. We were not able to find any correlation between curve correction or spine elongation and variations in cerebellar tonsillar position.
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spelling doaj.art-9cee38c04f5d4efa9629618ea385e31f2023-12-02T23:18:07ZengAsociación Argentina de Ortopedia y TraumatologíaRevista de la Asociación Argentina de Ortopedia y Traumatología1515-17861852-74342016-02-018112610.15417/504170Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic ScoliosisSantiago Tomas Bosio0Miguel Puigdevall1Jorge Hokama2Ruben Maenza3Hospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresHospital Italiano de Buenos AiresObjective:  To evaluate variations in cerebellar tonsil position after posterior spinal fusion (PSF) in neurologically intact patients with adolescent idiopathic scoliosis (AIS).  Methods: We retrospective evaluated 40 patients with AIS and no neurological symptoms that underwent PSF. Anteroposterior and sagittal standing radiographs, and sagittal hindbrain MRI were performed in all patients before and after spinal surgery.  The level of the cerebellar tonsil relative to the magnum foramen was measured according to the method described by Aboulezz (J Comput Assist Tomogr 1985). We evaluate variations in cerebellar tonsil position in relation to spinal correction and spinal elongation after PSF. Results: Mean preoperative magnitude of the curve was 53,15° (SD 10,46°) and thoracic kyphosis was 35,42º (SD 12,38°). Mean postoperative values were 7,45º (SD 7,33°)  and 27,87º (SD 9,03°), respectively. This represents 86% correction in the coronal plane (p<0.00001) and 25% of kyphosis variation (p<0.00001). The average length of the spine in the coronal plane was 44,5 cm (SD 5,25 cm) in preoperative x-rays and 48,27 cm (SD 4,40 cm) in postoperative x-rays (p<0.00001).  The average length in the sagittal plane was 50,87 cm (SD 4,47 cm) in preoperative x-rays and 55,13cm (SD 3,27 cm) in postoperative x-rays (p<0.00001). There was no significant difference in the position of the Cerebellar Tonsil before and after spinal correction (p=0,6042). In 10 (25%) of the 40 patients, we observed caudal displacement in cerebellar tonsil position after PSF. Average displacement in these patients was 1,22 mm (range 0.1-2.3 mm). In 21 patients we did not observe any variation and in 2 a cephalic displacement was measured. Conclusions:  In most AIS patients, position of the cerebellar tonsil does not change with PSF. We were not able to find any correlation between curve correction or spine elongation and variations in cerebellar tonsillar position.http://ojs.aaot.org.ar/ojsr/index.php/AAOTMAG/article/view/504Escoliosis idiopática del adolescenteamígdala cerebelosamalformación de Arnold-Chiariartrodesis vertebral posterior.
spellingShingle Santiago Tomas Bosio
Miguel Puigdevall
Jorge Hokama
Ruben Maenza
Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
Revista de la Asociación Argentina de Ortopedia y Traumatología
Escoliosis idiopática del adolescente
amígdala cerebelosa
malformación de Arnold-Chiari
artrodesis vertebral posterior.
title Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
title_full Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
title_fullStr Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
title_full_unstemmed Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
title_short Magnetic Resonance Imaging Evaluation of the Position of the Cerebellar Tonsil before and after Posterior Spinal Fusion in Adolescent Idiopathic Scoliosis
title_sort magnetic resonance imaging evaluation of the position of the cerebellar tonsil before and after posterior spinal fusion in adolescent idiopathic scoliosis
topic Escoliosis idiopática del adolescente
amígdala cerebelosa
malformación de Arnold-Chiari
artrodesis vertebral posterior.
url http://ojs.aaot.org.ar/ojsr/index.php/AAOTMAG/article/view/504
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