Article Figures & Data
Figures
- FIG 1.
Morphometric measurements on a presurgery MR image (A) and a postsurgery MR image (B) for the same patient 1 year later. 1) CSF area posterior to PCF, 2) anterior CSF area, 3) posterior CSF area, 4) cerebellar height, 5a) posterior dorsal width + (5b) anterior dorsal width = total dorsal CSF width, 6) ventral CSF width, 7) cerebellar tonsillar position, 8) occipital bone length, and 9) cerebellum-clivus bone angle. Note that the syrinx in the presurgical MR image resolved after surgery (Supplemental Online Video).
- FIG 2.
Morphometric length, angle, and CSF area measurements (LS-means and 95% CI). A, CSF area posterior to the PCF. B, Posterior CSF area. A and B, RM-ANOVA F-test (df = 6) of TP: P value < .0001. C, Anterior CSF area for CMI-only, and for patients with CMI plus syringomyelia; C, RM-ANCOVA (diagnosis as a covariate), F-test (df = 6) for the interaction (diagnosis × TP): P = .0374. RM-ANOVA F-test (df = 6) for TP: P > .05 for CMI-only, no multiple comparisons: P < .0001 for CMI and syringomyelia (SM). D, Cerebellar height. E, Total dorsal width. F, Ventral CSF width. G, Cerebellar tonsillar position, H, Occipital bone length. I, Cerebellum-clivus bone angle. RM-ANOVA F-test (df = 6) of TP: P value < .0001 except for ventral CSF width (P = .023, F). Hash tag indicates the Dunnett adjusted P value < .05 at the TP compared with TP = –0.5; plus sign, the Dunnett adjusted P value < .05 at the TP compared with TP = +0.5; asterisk, the Dunnett adjusted P value < .01 at the TP compared with TP = –0.5.
- FIG 3.
Clinical outcomes (back-transformed LS-means and 95% CI): A, KPS score. B, Average pain. C, Mean continuous pain. D, Mean intermittent pain. E, Mean affective pain. F, Mean neuropathic pain. RM-ANOVA F-test (df = 6) of TP: P value < .005. The asterisk indicates the Dunnett adjusted P value < .05 at the TP compared with TP = –0.5.
Tables
- Table 1:
Number of subjects at each TP category for clinical outcomes and morphometric measurements
TP categories TP (yr) –0.5 0.5 1 2 3 4 5 Relative to surgery (mo) –9 to –1 0–9 9–18 18–30 30–42 42–54 >54 Number of subjects for each TP Morphometric measurements 38 35 31 23 19 17 14 KPS score 36 34 32 24 22 16 14 Average pain 34 33 32 23 21 14 14 Mean of affective pain 34 33 32 23 21 14 14 Mean of continuous pain 33 33 32 23 21 14 14 Mean of intermittent pain 34 33 32 23 21 14 14 Mean of neuropathic pain 34 33 32 23 21 14 14 ASIA total score 35 35 33 23 24 17 14 Ambulatory score 35 35 33 24 24 17 14 Cognitive subtotal 35 35 32 24 22 16 14 McCormick class score 35 35 32 24 24 17 14 Motor subtotal 35 35 32 24 22 16 14 Total FIM 35 35 32 24 22 16 14 Note:—ASIA indicates American Spinal Injury Association; FIM, Functional Independence Measure.
Morphometric Measurement Description Area 1 CSF area posterior to PCF (mm2) CSF area posterior to a line drawn between the IOP and opisthion, and posterior to the cerebellum 2 Anterior CSF area (mm2) CSF area in the upper cervical spinal canal anterior to the spinal cord between the FM and inferior limit of the C2 vertebra 3 Posterior CSF area (mm2) CSF area in the upper cervical spinal canal posterior to the spinal cord between the FM and inferior limit of the C2 vertebra Length 4 Cerebellar height (mm) Distance between the most superior point of the superior vermis and the most inferior point of the tonsil 5 Total dorsal CSF width (mm) Width of the CSF space measured at the level of the FM, anterior to the cerebellum, posterior to the brainstem and posterior the cerebellum, anterior to the subarachnoid space 6 Ventral CSF width (mm) Width of the CSF space measured at the level of the FM, anterior to the brainstem, posterior to the subarachnoid space 7 Cerebellar tonsillar position (mm) The perpendicular distance between the most inferior tip of the cerebellar tonsils and the McRae line 8 Occipital bone length (mm) Length between a point at the midpoint of the occipital bone at the level of the tentorium and IOP and the most inferior tip of the occipital bone Angle 9 Cerebellum-clivus bone angle (degree) The angle subtended by the major axis of the cerebellum with the posterior margin of the clivus bone Note:—IOP indicates internal occipital protuberance; FM, foramen magnum.
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