Vadivelu Sathya, Vadivelu Sudhakar, Mealy Maureen, Patel Smurti, Kosnik-Infinger Libby, Becker Daniel
a Department of Pediatric Rehabilitation Medicine , Johns Hopkins University and the Kennedy Krieger Institute , Baltimore , MD , USA.
b Division of Pediatric Neurosurgery , Cincinnati Children's Hospital Medical Center , Cincinnati , OH , USA.
Dev Neurorehabil. 2018 Aug;21(6):402-407. doi: 10.1080/17518423.2017.1323972. Epub 2017 May 24.
Transverse myelitis (TM) is an acute inflammatory spinal cord injury. Asymptomatic Chiari I malformation (CMI) management is highly controversial, particularly when associated with a spinal syrinx. Here, we assess the occurrence of CMI in the pediatric TM population and management outcomes.
We performed a retrospective cohort study based on 61 consecutively identified pediatric TM cases over an -8-year period. We reviewed demographic characteristics, radiographic findings, presenting symptoms, and long-term outcomes.
Eight CMI cases were identified within the TM cohort; all presented with TM by 16 months of age and affecting the cervical spinal cord. In three cases, CMI developed 15 months to 6 years after the onset of TM. One in 10 children with TM had CMI.
These findings demonstrate a high prevalence of CMI in patients with TM. Large prospective clinical studies are needed to further investigate the natural history and recovery strategies of CMI involved with neuroinflammatory disorders.
横贯性脊髓炎（TM）是一种急性炎症性脊髓损伤。无症状Chiari I型畸形（CMI）的处理极具争议，尤其是当合并脊髓空洞症时。在此，我们评估小儿TM人群中CMI的发生率及处理结果。
我们基于连续8年中确诊的61例小儿TM病例进行了一项回顾性队列研究。我们回顾了人口统计学特征、影像学检查结果、临床表现及长期预后。
在TM队列中发现8例CMI病例；所有病例在16个月龄前均出现TM，且累及颈髓。3例CMI在TM发病后15个月至6年出现。每10例TM患儿中有1例患有CMI。
这些发现表明CMI在TM患者中患病率较高。需要开展大型前瞻性临床研究，以进一步探究与神经炎性疾病相关的CMI的自然病程及恢复策略。
