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

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Published: Feb 19, 2016
DOI: https://doi.org/10.15417/504
Keywords:
Adolescent Idiopathic Scoliosis, Cerebellar Tonsil, Arnold Chiari, Posterior Spinal Fusion.

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Santiago Tomas Bosio
Hospital Italiano de Buenos Aires
http://orcid.org/0000-0002-8361-3317
Miguel Puigdevall
Hospital Italiano de Buenos Aires
http://orcid.org/0000-0002-1434-9727
Jorge Hokama
Hospital Italiano de Buenos Aires
http://orcid.org/0000-0002-6169-6975
Ruben Maenza
Hospital Italiano de Buenos Aires
http://orcid.org/0000-0001-7780-7556

Abstract

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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How to Cite
Bosio, S. T., Puigdevall, M., Hokama, J., & Maenza, R. (2016). 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, 81(1), 2-6. https://doi.org/10.15417/504
Issue
Vol 81 No 1 (2016)
Section
Clinical Research
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Author Biography

Santiago Tomas Bosio, Hospital Italiano de Buenos Aires

Ortopedia y Traumatologia. Sector Centro de escoliosis pediatrica del Hospiotal italiano de Buenos Aires. Medico de Planta.

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