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首页> 外文期刊>Spine >Variations of the position of the cerebellar tonsil in idiopathic scoliotic adolescents with a cobb angle >40 degrees: a magnetic resonance imaging study.
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Variations of the position of the cerebellar tonsil in idiopathic scoliotic adolescents with a cobb angle >40 degrees: a magnetic resonance imaging study.

机译：柯布角> 40度的特发性脊柱侧凸青少年小脑扁桃体位置的变化：磁共振成像研究。

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STUDY DESIGN: A retrospective study was performed through measurements on MRI images in adolescent idiopathic scoliosis (AIS) patients and age-matched adolescents. OBJECTIVES: To investigate the position of the cerebellar tonsil in AIS patients with a Cobb angle >40 degrees in comparison with age-matched healthy adolescents and to determine the relationships of the tonsil position with age, sex, curve severity, and curve patterns. SUMMARY OF BACKGROUND DATA: There have been increasing evidences implying that AIS patients may present with subtle or subclinical neurologic dysfunction and a higher incidence of tonsillar ectopia was documented in AIS patients. However, the tonsil position has not been clearly addressed in AIS patients with a severe curve. METHODS: According to the method described by Aboulezz et al, measurements of the tonsil position relative to the magnum foramen on magnetic resonance images were performed in 203 AIS patients with a Cobb angle >40 degrees and 86 age-matched healthy adolescents. The inferior displacement of the cerebellar tonsil with an extent within 5 mm was defined as tonsillar ectopia when it located below the magnum foramen. On the basis of measurement results, the incidence of tonsillar ectopia was determined in both AIS and control groups. The associations of tonsillar ectopia with curve severity and curve patterns for AIS patients and the relationships of the tonsil positions with age and gender in all subjects were analyzed. RESULTS: In AIS patients and healthy controls, the median position of the cerebellar tonsil was 0.8 and 2.9 mm above the magnum foramen, respectively. The incidence of tonsillar ectopia (0-4.8 mm below the magnum foramen) in AIS was found to be significantly higher than healthy adolescents (range 0-1.8 mm vs. 0-4.8 mm below the magnum foramen; ratio 34.5% vs. 5.8%; P < 0.01). No significant correlations were found between the position of the cerebellar tonsil with age or gender in AIS and control subjects. It was shown the position of the cerebellar tonsil was not significantly different among AIS patients with different curve severity. However, it was noted that there was a highest incidence (62.5%) of tonsillar ectopia in atypical scoliotic cases with a double thoracic curve. Additionally, a significantly higher incidence of tonsillar ectopia was found in patients with thoracic or thoracolumbar curves when compared with those with lumbar curves (37.4% vs. 21.6%, P = 0.049). CONCLUSION: Tonsillar ectopia with the extent >2 mm in AIS patients should be regarded as abnormal. AIS patients had a lower tonsil position and a higher prevalence of tonsillar ectopia than controls, and tonsillar ectopia was found to be associated with curve patterns. It is suggested that a lower position of the cerebellar tonsil might be associated with the etiopathogenesis of AIS and might contribute to subclinical neurologic dysfunction in AIS patients.
机译：研究设计：通过对青少年特发性脊柱侧弯（AIS）患者和年龄匹配的青少年的MRI图像进行测量，进行了一项回顾性研究。目的：调查与年龄匹配的健康青少年相比，Cobb角> 40度的AIS患者小脑扁桃体的位置，并确定扁桃体位置与年龄，性别，曲线严重度和曲线模式的关系。背景数据概述：越来越多的证据表明AIS患者可能表现为轻微或亚临床神经功能障碍，并且有证据表明AIS患者的扁桃体性近视发生率更高。然而，对于严重弯曲的AIS患者，扁桃体位置尚未明确解决。方法：根据Aboulezz等人描述的方法，在203例Cobb角> 40度的AIS患者和86名年龄匹配的健康青少年中，对磁共振图像上扁桃体相对于大孔的位置进行了测量。当小脑扁桃体位于大孔以下时，其下移位在5mm以内被定义为扁桃体异物。根据测量结果，确定了AIS组和对照组的扁桃体性近视的发生率。分析了AIS患者扁桃体外翻与弯曲严重度和弯曲模式的关系，以及所有受试者中扁桃体位置与年龄和性别的关系。结果：在AIS患者和健康对照者中，小脑扁桃体的中位分别比大指孔高0.8和2.9 mm。发现AIS中扁桃体异物的发生率（在大孔以下0-4.8毫米）显着高于健康的青少年（范围在0-1.8毫米与大孔以下0-4.8毫米之间;比率为34.5％对5.8％。 ; P <0.01）。在AIS和对照组中小脑扁桃体的位置与年龄或性别之间未发现显着相关性。结果表明，不同曲度的AIS患者小脑扁桃体位置无明显差异。但是，应注意的是，非典型脊柱侧凸病例的双胸廓曲线性扁桃体性近视发生率最高（62.5％）。此外，与有腰椎弯曲的患者相比，有胸或胸腰弯的患者扁桃体性近视的发生率显着更高（37.4％vs. 21.6％，P = 0.049）。结论：AIS患者的扁桃体性近视> 2 mm应视为异常。与对照组相比，AIS患者的扁桃体位置较低，扁桃体异位患病率更高，发现扁桃体异位与曲线型有关。提示小脑扁桃体位置低可能与AIS的病因有关，可能与AIS患者的亚临床神经功能障碍有关。

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