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Patients with Chiari malformation without syringomyelia show less severe scoliosis curves

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SAN FRANCISCO — Patients with Chiari malformation I-associated scoliosis in the absence of syringomyelia have less severe scoliotic curves, fewer left-facing curves and present with less physical symptoms compared to patients with Chiari malformation I and syringomyelia, according to a study presented at the American Association of Neurological Surgeons Annual Meeting.

“Given these results and the saggital profile, we still continue to believe that those patients who have Chiari malformation and scoliosis that the scoliosis results from the underlying neurological disease, not necessarily representing a major level of scoliosis in the population,” Jakub Godzik, BA, said, here.

Godzik presented results of a retrospective study in which researchers reviewed the medical records at Washington University in St. Louis from 2000 and 2013. They identified patients younger than 18 years old who had Chiari I malformation (CIM) with scoliosis in the absence of syringomyelia. Patients were matched by age and gender to patients who have CIM with scoliosis and syringomyelia. They compared the groups’ initial curve patterns, imaging characteristics and physical findings.

Overall, Godzik and colleagues identified 524 patients with CIM, of which 18 patients were found to have CIM-associated scoliosis in the absence of syringomyelia, for a prevalence of 3.3%. Four patients were male with a mean age of 11.5 years.

Patients without syringomyelia were found to have less severe scoliotic curves (30.2°) compared to the patients with syringomyelia (50.3°). However, the researchers noted that both groups had a comparable amount of hyperkyphosis (46° vs. 51°). Two patients without syringomyelia had left-facing deformities compared with left-facing deformities in 50% of the patients with CIM and syringomyelia. The researchers found 33% of the patients with CIM and syringomyelia had neurological deficits, however, no patients without syringomyelia showed similar neurological deficits. – by Kristine Houck, MA, ELS

Reference:

Godzik J. Paper #654. Presented at: American Association of Neurological Surgeons Annual Meeting; April 5-9, 2014; San Francisco.

Disclosure: Godzik has no relevant financial disclosures.