Scoliosis in patients with Chiari malformation type I

Mohammad Hassan A. Noureldine, Nir Shimony, George I. Jallo, Mari L. Groves

Research output: Contribution to journalArticlepeer-review

Abstract

The literature about the association between Chiari malformations (CMs) and scoliosis has been growing over the last three decades; yet, no consensus on the optimal management approach in this patient population has been reached. Spinal anomalies such as isolated syrinxes, isolated CM, and CM with a syrinx are relatively common among patients with presumed idiopathic scoliosis (IS), a rule that also applies to scoliosis among CM patients as well. In CM patients, scoliosis presents with atypical features such as early onset, left apical or kyphotic curvature, and neurological deficits. While spinal X-rays are essential to confirm the diagnosis of scoliosis among CM patients, a magnetic resonance imaging (MRI) is also recommended in IS patients with atypical presentations. Hypotheses attempting to explain the occurrence of scoliosis in CM patients include cerebellar tonsillar compression of the cervicomedullary junction and uneven expansion of a syrinx in the horizontal plane of the spinal cord. Early detection of scoliosis on routine spinal examination and close follow-up on curve stability and progression are essential initial steps in the management of scoliosis, especially in patients with CM, who may require full spine MRI to screen for associated neuro-axial anomalies; bracing and spinal fusion may be subsequently pursued in high-risk patients.

Original languageEnglish (US)
Pages (from-to)1853-1862
Number of pages10
JournalChild's Nervous System
Volume35
Issue number10
DOIs
StatePublished - Oct 1 2019

Keywords

  • Chiari malformation
  • Cobb angle
  • Curve progression
  • Left apical curve
  • Posterior fossa
  • Scoliosis
  • Spinal fusion
  • Suboccipital decompression
  • Syringomyelia
  • Syrinx

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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