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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticleSpine Imaging and Spine Image-Guided Interventions
Open Access

Tapering of the Cervical Spinal Canal in Patients with Distended or Nondistended Syringes Secondary to Chiari Type I Malformation

Z. Zhu, S. Sha, X. Sun, Z. Liu, H. Yan, W. Zhu, Z. Wang and Y. Qiu
American Journal of Neuroradiology October 2014, 35 (10) 2021-2026; DOI: https://doi.org/10.3174/ajnr.A3967
Z. Zhu
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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S. Sha
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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X. Sun
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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Z. Liu
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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H. Yan
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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W. Zhu
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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Z. Wang
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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Y. Qiu
aFrom the Department of Spine Surgery, Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.
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  • Fig 1.
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    Fig 1.

    Sagittal T2-weighted MR image illustrating the measurement of the anteroposterior spinal canal diameter at 7 cervical levels.

  • Fig 2.
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    Fig 2.

    Plot of diameters of the cervical spinal canal for the patient in Fig 1 and the fitting of a trend line. The slope is −0.39 mm/level, with the negative sign indicating the taper toward C7.

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    Fig 3.

    Two adolescents with Chiari malformation and syringomyelia. A, A 13-year-old male with nondistended syrinx. The taper ratios for C1–C7, C1–C4, and C4–C7 are −1.52, −2.76, and −0.22, respectively. B, A 12-year-old female with distended syrinx. The taper ratios for C1–C7, C1–C4, and C4–C7 are 0.79, 0.63, and 0.50, respectively.

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    Fig 4.

    Average anteroposterior diameters of the cervical spinal canal plotted by cervical level in the 2 groups.

Tables

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    Table 1:

    Clinical and radiographic characteristics of patients in the 2 groups

    Group DGroup NDP
    Number4433
    Age (years)14.0 ± 2.0 (10–18)14.6 ± 1.9 (10–18)NS
    Sex (male/female)26/1820/13NSa
    Extent of tonsillar descentNSa
        Grade I2517
        Grade II1615
        Grade III31
    Syrinx locationNSb
        Proximal levelC2–C5C2–C6
        Distal levelC6–T4C6–T3
    Syrinx/cord ratio0.70 ± 0.10 (0.51–0.88)0.39 ± 0.09 (0.19–0.50)<.001
    Taper ratio (mm/level)
        C1–C7−0.34 ± 0.54 (−2.03–0.81)−0.73 ± 0.57 (−1.88–0.98).001c
        C1–C4−0.98 ± 0.87 (−2.47–1.70)−1.61 ± 0.98 (−3.66–0.85).004c
        C4–C70.24 ± 0.50 (−0.85–1.65)−0.04 ± 0.54 (−0.97–1.36).033c
    • Note:—NS indicates statistical nonsignificance.

    • ↵a χ2 test.

    • ↵b Fisher exact test.

    • ↵c Kruskal–Wallis test or otherwise Student t test.

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    Table 2:

    Analyses of the taper ratio for C1–C7 with respect to age and gender

    Group DGroup ND
    NTaper RatioNTaper Ratio
    Age
        ≤14 years28−0.26 ± 0.5512−0.77 ± 0.46
        >14 years16−0.49 ± 0.5321−0.71 ± 0.63
        P.380.750
    Sex
        Male26−0.39 ± 0.5620−0.72 ± 0.70
        Female18−0.27 ± 0.5313−0.75 ± 0.27
        P.358.883
    Extent of tonsillar descent
        Grade I25−0.34 ± 0.6217−0.79 ± 0.50
        Grade II16−0.29 ± 0.4615−0.61 ± 0.63
        Grade III3−0.56 ± 0.381−1.37
        P.525.335
    • Note:—Statistical significance was tested using the Kruskal–Wallis test.

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American Journal of Neuroradiology: 35 (10)
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Tapering of the Cervical Spinal Canal in Patients with Distended or Nondistended Syringes Secondary to Chiari Type I Malformation
Z. Zhu, S. Sha, X. Sun, Z. Liu, H. Yan, W. Zhu, Z. Wang, Y. Qiu
American Journal of Neuroradiology Oct 2014, 35 (10) 2021-2026; DOI: 10.3174/ajnr.A3967
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Cite this article
Z. Zhu, S. Sha, X. Sun, Z. Liu, H. Yan, W. Zhu, Z. Wang, Y. Qiu
Tapering of the Cervical Spinal Canal in Patients with Distended or Nondistended Syringes Secondary to Chiari Type I Malformation
American Journal of Neuroradiology Oct 2014, 35 (10) 2021-2026; DOI: 10.3174/ajnr.A3967

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