Silva Karl Marx S, Silva Leandro M, Nascimento José J C, Soares Áquila M, Bandeira Wigínio G L, Araújo-Neto Severino A, Medeiros Juliana P
Center of Medical Sciences, Federal University of Pernambuco, Recife, Brazil.
Department of Anatomy, Postgraduate Program in Neuropsychiatry, Federal University of Pernambuco, Recife, Brazil.
World Neurosurg. 2024 Nov;191:e373-e380. doi: 10.1016/j.wneu.2024.08.133. Epub 2024 Aug 31.
To evaluate the effect of the basilar invagination (BI) type B on cervical spine.
The research protocol used head magnetic resonance imaging (MRI) exams from 41 participants with BI type B and 158 controls. The criterion for BI was the distance of the odontoid apex to Chamberlain's line (DOCL) equal to or greater than 7 mm. The clivus length (CLI), clivus canal angle (CCA), Welcker's basal angle (WBA), Boogaard's angle (BOA), upper cervical lordosis angle (UCL), and total cervical lordosis angle (CL) were evaluated. The descriptive analysis, group comparisons, and correlations between skull base and cervical spine parameters were performed at the 95% CI.
Participants with BI type B showed shorter clivus length (CLI: 25.7 ± 7.3 mm); greater angulation of the skull base (WBA: 126.5 ± 10.4); greater inclination foramen magnum (BOA: 151.5 ± 14.5); decrease in the value of the CCA (131.6 ± 15); and greater angulations of UCL (17.9 ± 13.8) and CL (29.7 ± 19.9) in comparison to the control group (P < 0.05). Clivus length and CCA correlated inversely with UCL and CL, while BOA correlated directly with UCL and CL. The WBA did not correlate with CL (P < 0.05).
The deformation of skull base in the BI of type B caused, on average, a hyperlordosis of almost 30° in the C2-C6 segment. This change was approximately 17° in the C2-C4, with the clivus hypoplasia being a risk factor for cervical hyperlordosis.
评估B型颅底陷入症（BI）对颈椎的影响。
本研究方案采用了41例B型BI参与者和158例对照者的头部磁共振成像（MRI）检查。BI的标准为齿状突尖至钱伯林线（DOCL）的距离等于或大于7mm。评估斜坡长度（CLI）、斜坡管角（CCA）、韦尔克基底角（WBA）、布加德角（BOA）、上颈椎前凸角（UCL）和总颈椎前凸角（CL）。在95%置信区间进行描述性分析、组间比较以及颅底与颈椎参数之间的相关性分析。
与对照组相比，B型BI参与者的斜坡长度较短（CLI：25.7±7.3mm）；颅底角度更大（WBA：126.5±10.4）；枕骨大孔倾斜度更大（BOA：151.5±14.5）；CCA值降低（131.6±15）；UCL（17.9±13.8）和CL（29.7±19.9）角度更大（P<0.05）。斜坡长度和CCA与UCL和CL呈负相关，而BOA与UCL和CL呈正相关。WBA与CL无相关性（P<0.05）。
B型BI中颅底的变形平均导致C2-C6节段近30°的过度前凸。C2-C4节段的这种变化约为17°，斜坡发育不全是颈椎过度前凸的一个危险因素。
