Spinal and cranial morphometric features of chiari malformation patients undergoing decompression surgery

Abstract

Chiari malformation (CM) is characterized by herniation of the cerebellar tonsil(s) and/or medulla oblongata into the spinal canal, resulting in various morphometric abnormalities. The current study aimed to evaluate the magnetic resonance imaging (MRI) findings and morphometric features of the craniocervical region in patients who underwent surgery for CM. Demographic and radiological data were collected from 59 patients who underwent surgery for CM and a control group of 58 randomly selected nonsurgical patients. For between-group comparisons, Continuous variables were described as the mean (±SD) or median (IQR) and categorical variables as frequency (%). The mean age of the control group participants was 33.38 years. The mean age of patients in the CM group at the time of surgery was 33.83 years. The diameter of the foramen magnum, the maximum anteroposterior diameter of the C1 vertebra, the maximum diameter of the spinal canal at the C2 vertebra, and the atlantodental interval were all positively correlated with the total cerebellar tonsil length [r=0.54, 0.37, 0.42, 0.71]. Comparisons of total cerebellar tonsil length with other morphological and clinical variables, including contact between the brainstem and clivus, basilar invagination, preoperative hydrocephalus, remnant cartilage between the odontoid and C2 corpus, and associated craniovertebral junction anomalies, revealed no other significant correlations. CM is associated with many structural anomalies in the brain. However, there is relatively little detail in the existing literature on the morphometric parameters associated with the malformation. The findings of this study provide insights for future research and contribute to knowledge of the morphometric features of CMs in general and CMs in patients requiring surgical management in particular.