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Review
. 2015 Oct;26(4):579-85.
doi: 10.1016/j.nec.2015.06.005. Epub 2015 Aug 4.

Spinal Deformity Associated with Chiari Malformation

Michael P Kelly  1 , Tenner J Guillaume  2 , Lawrence G Lenke  3
Affiliations
Review

Spinal Deformity Associated with Chiari Malformation

Michael P Kelly et al. Neurosurg Clin N Am. 2015 Oct.

Abstract

Despite the frequency of Chiari-associated spinal deformities, this disease process remains poorly understood. Syringomyelia is often present; however, this is not necessary and scoliosis has been described in the absence of a syrinx. Decompression of the hindbrain is often recommended. In young patients (<10 years old) and/or those with small coronal Cobb measurements (<40°), decompression of the hindbrain may lead to resolution of the spinal deformity. Spinal fusion is reserved for those curves that progress to deformities greater than 50°. Further research is needed to understand the underlying pathophysiology to improve prognostication and treatment of this patient population.

Keywords: Chiari malformation; Early onset; Scoliosis; Syringomyelia; Syrinx.

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Figures

Figure 1
Figure 1
a – Standing postero-anterior radiograph of a 17 year old girl with typical radiographic findings of adolescent idiopathic scoliosis: apex right, no angular deformity b – Standing lateral radiograph showing thoracic hypokyphosis, typical of adolescent idiopathic scoliosis. c – Standing clinical image showing a loss of thoracic kyphosis. d - Lateral forward bending clinical image showing a loss of thoracic kyphosis.
Figure 1
Figure 1
a – Standing postero-anterior radiograph of a 17 year old girl with typical radiographic findings of adolescent idiopathic scoliosis: apex right, no angular deformity b – Standing lateral radiograph showing thoracic hypokyphosis, typical of adolescent idiopathic scoliosis. c – Standing clinical image showing a loss of thoracic kyphosis. d - Lateral forward bending clinical image showing a loss of thoracic kyphosis.
Figure 1
Figure 1
a – Standing postero-anterior radiograph of a 17 year old girl with typical radiographic findings of adolescent idiopathic scoliosis: apex right, no angular deformity b – Standing lateral radiograph showing thoracic hypokyphosis, typical of adolescent idiopathic scoliosis. c – Standing clinical image showing a loss of thoracic kyphosis. d - Lateral forward bending clinical image showing a loss of thoracic kyphosis.
Figure 1
Figure 1
a – Standing postero-anterior radiograph of a 17 year old girl with typical radiographic findings of adolescent idiopathic scoliosis: apex right, no angular deformity b – Standing lateral radiograph showing thoracic hypokyphosis, typical of adolescent idiopathic scoliosis. c – Standing clinical image showing a loss of thoracic kyphosis. d - Lateral forward bending clinical image showing a loss of thoracic kyphosis.
Figure 2
Figure 2
a - Standing postero-anterior radiograph of a 13 year old girl with “typical” coronal plane findings of adolescent idiopathic scoliosis. b – Standing lateral radiograph showing proximal thoracic kyphosis, “atypical” for adolescent idiopathic scoliosis. c – Lateral clinical image of 13 year old girl with proximal thoracic kyphosis. d – T2-Weighted magnetic resonance imaging of this young woman, showing Chiari-I with syringomyelia.
Figure 2
Figure 2
a - Standing postero-anterior radiograph of a 13 year old girl with “typical” coronal plane findings of adolescent idiopathic scoliosis. b – Standing lateral radiograph showing proximal thoracic kyphosis, “atypical” for adolescent idiopathic scoliosis. c – Lateral clinical image of 13 year old girl with proximal thoracic kyphosis. d – T2-Weighted magnetic resonance imaging of this young woman, showing Chiari-I with syringomyelia.
Figure 2
Figure 2
a - Standing postero-anterior radiograph of a 13 year old girl with “typical” coronal plane findings of adolescent idiopathic scoliosis. b – Standing lateral radiograph showing proximal thoracic kyphosis, “atypical” for adolescent idiopathic scoliosis. c – Lateral clinical image of 13 year old girl with proximal thoracic kyphosis. d – T2-Weighted magnetic resonance imaging of this young woman, showing Chiari-I with syringomyelia.
Figure 2
Figure 2
a - Standing postero-anterior radiograph of a 13 year old girl with “typical” coronal plane findings of adolescent idiopathic scoliosis. b – Standing lateral radiograph showing proximal thoracic kyphosis, “atypical” for adolescent idiopathic scoliosis. c – Lateral clinical image of 13 year old girl with proximal thoracic kyphosis. d – T2-Weighted magnetic resonance imaging of this young woman, showing Chiari-I with syringomyelia.
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References

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