Botelho Ricardo V, Petranchi Beatriz Cibin Braga, Botelho Pedro B, Moreira Diego U M, Bertolini Eduardo F, Rotta José M
IAMSPE. Department of Neurosurgery. Hospital do Servidor Público Estadual, São Paulo, São Paulo, Brazil.
Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, São Paulo, Brazil.
World Neurosurg X. 2024 Sep 26;25:100418. doi: 10.1016/j.wnsx.2024.100418. eCollection 2025 Jan.
Type I Basilar invagination is associated with the assimilation of the anterior arch of the atlas. Observation suggests that the assimilation of the atlas does not allow the development of the normal space between the skull and C1 and displaces the high cervical spine towards the neural structures, posteriorly positioned. Purpose: The objective of this work is to evaluate craniospinal alignment in patients with type I Basilar invagination and AOA in comparison with normal subjects (Type I).
Magnetic resonance images and / or CT SCAN with reconstruction in the midline, in acquisitions at t1 and or t2, from 30 normal subjects and 27 patients with type I Basilar invagination were evaluated. The position of Anterior arch of Atlas and odontoid process in relation to the Basion and distances between C1 and C2 to the anterior border of foramen magnum were compared between groups.
The distance from C2 to the Basion was significantly higher in the BI group than in the control group (t test: t = 4.18; p = 0) and the space between the skull and Atlas was reduced. All normal subjects had the Atlas anteriorly located in relation to the Basion. In AOA, all patients had Atlas in line with or posteriorly dislocated in relation to the Basion and the Odontoid process occupying the foramen magnum space.
data revealed that AOA prevents a normal position of skull in relation to the Atlas and a presumed "slip-back" cranio-spinal displacement during developmental period.
I型基底凹陷与寰椎前弓融合相关。观察表明，寰椎融合不允许颅骨与C1之间正常间隙的发育，并使高位颈椎向后移位靠近神经结构。目的：本研究的目的是评估I型基底凹陷和寰椎前弓融合患者与正常受试者（I型）相比的颅颈排列情况。
对30名正常受试者和27名I型基底凹陷患者的磁共振图像和/或t1和/或t2采集的中线重建CT扫描进行评估。比较两组之间寰椎前弓和齿突相对于颅底的位置以及C1和C2至枕骨大孔前缘的距离。
基底凹陷组中C2至颅底的距离显著高于对照组（t检验：t = 4.18；p = 0），颅骨与寰椎之间的间隙减小。所有正常受试者的寰椎相对于颅底位于前方。在寰椎前弓融合中，所有患者的寰椎与颅底对齐或相对于颅底向后脱位，齿突占据枕骨大孔空间。
数据显示，寰椎前弓融合在发育期间阻止了颅骨相对于寰椎的正常位置以及推测的“向后滑动”的颅颈移位。
