Journal of craniovertebral junction & spine · 2026
An examination of atlanto-occipital curvature in adult Chiari malformation type 1 and control groups.
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Karamzadeh Mahsa, Al Samman Mohamad Motaz, Labuda Rick, Bhadelia Rafeeque A, Millard Jonathan A, Bishop Paul D, Allen Philip A, Fultz Thomas J, Raymond Scott B, Tsai Jenny P, Hussain Muhammad Shazam, Amini Rouzbeh, Loth Francis
Аннотация
OBJECTIVE: To compare computed tomography (CT) scan-based morphometric measures associated with atlanto-occipital joint (AOJ) instability between Chiari malformation type I (CMI) patients and controls and to examine associations between these measures, clinical symptoms, and established craniocervical/posterior fossa morphometrics in CMI.
MATERIALS AND METHODS: Four AOJ-related morphometric measures were evaluated on CT: condyle-C1 interval (CCI), C1 socket depth-to-length ratio (DL ratio), condyle depth-to-depth ratio (CD ratio), and atlas tilt angle. Measurements were compared between CMI (n = 45) and controls (n = 55). Within CMI, associations were tested between AOJ measures and symptom variables, as well as 13 established craniocervical/posterior fossa morphometrics.
RESULTS: Mean CCI was slightly larger in CMI than in controls (1.00 vs. 0.91 mm, P < 0.05). DL ratio, CD ratio, and atlas tilt angle did not differ significantly between groups. Within CMI, CCI showed a modest association with hypermobility (r = 0.34, P < 0.05). Moderate correlations were observed between AOJ measures and selected morphometrics, suggesting relationships between AOJ geometry and posterior fossa/craniocervical anatomy.
CONCLUSION: Among the AOJ measures examined, only CCI demonstrated a small but statistically significant group difference and a modest association with hypermobility in CMI. The shape of the AOJ curvature was not different between CMI and control. However, further investigation of AOJ-related morphometrics as potential contributors to symptom heterogeneity among CMI patients is necessary.
MATERIALS AND METHODS: Four AOJ-related morphometric measures were evaluated on CT: condyle-C1 interval (CCI), C1 socket depth-to-length ratio (DL ratio), condyle depth-to-depth ratio (CD ratio), and atlas tilt angle. Measurements were compared between CMI (n = 45) and controls (n = 55). Within CMI, associations were tested between AOJ measures and symptom variables, as well as 13 established craniocervical/posterior fossa morphometrics.
RESULTS: Mean CCI was slightly larger in CMI than in controls (1.00 vs. 0.91 mm, P < 0.05). DL ratio, CD ratio, and atlas tilt angle did not differ significantly between groups. Within CMI, CCI showed a modest association with hypermobility (r = 0.34, P < 0.05). Moderate correlations were observed between AOJ measures and selected morphometrics, suggesting relationships between AOJ geometry and posterior fossa/craniocervical anatomy.
CONCLUSION: Among the AOJ measures examined, only CCI demonstrated a small but statistically significant group difference and a modest association with hypermobility in CMI. The shape of the AOJ curvature was not different between CMI and control. However, further investigation of AOJ-related morphometrics as potential contributors to symptom heterogeneity among CMI patients is necessary.