Basilar Invagination Diagnosis, Classification, and Radiology: WFNS Spine Committee Recommendations.

IF 2.6 2区 医学 Q2 CLINICAL NEUROLOGY
Spine Pub Date : 2025-06-01 Epub Date: 2025-02-18 DOI:10.1097/BRS.0000000000005308
Onur Yaman, Mehmet Zileli, İdris Avci, Zan Chen, June Ho Lee, Geraldo Sá-Carneiro, Francesco Costa, Said Ait Ben Ali, Fernando Dantas, Joachim Oertel, Massimiliano Visocchi, Jutty Parthiban, Atul Goel, Ricardo Botelho, Oscar L Alves
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引用次数: 0

Abstract

Study design: A systematic literature review and consensus using Delphi method.

Objective: This review aimed to analyze recent literature on diagnosis, classification, and radiologic characteristics of Basilar Invagination (BI) to generate recommendations on these topics.

Summary of background: Basilar invagination diagnosis, classifications, and radiologic characteristics evolved during the last decade; however, many debatable criteria disturb a common language fundamental to compare clinical research.

Material and methods: The WFNS Spine Committee organized two separate consensus meetings to discuss and create statements that were voted on to reach a consensus.

Results: Basilar invagination mainly results from a CVJ developmental abnormality and is often associated with congenital anomalies. There is also an acquired type that occurs by bone softening, such as rheumatoid arthritis. It can be classified as type I (atlantoaxial dislocation) and type II (without atlantoaxial dislocation) basilar invagination. Clinical signs may either be due to brainstem compression or cervical spinal cord compression and instability. Although many radiologic measurements are proposed, the most reliable ones are the McRae line, Chamberlain line, and Boogard angle.

Conclusions: Diagnosis of basilar invagination should be made by midsagittal craniocervical x-rays, CTs or MRI. There are two types of basilar invagination: type I basilar invagination is associated with instability, and treatment can focus on stabilization. However, type II basilar invagination may need decompressive surgeries.

颅底内陷的诊断、分类和放射学:WFNS脊柱委员会的建议。
研究设计:采用德尔菲法进行系统的文献回顾和共识。目的:本综述旨在分析最近关于基底内陷(BI)的诊断、分类和放射学特征的文献,以对这些主题提出建议。背景概述:颅底凹陷的诊断、分类和放射学特征在过去十年中不断发展;然而,许多有争议的标准扰乱了比较临床研究的共同语言基础。材料和方法:WFNS脊柱委员会组织了两次单独的共识会议来讨论和创建声明,并对其进行投票以达成共识。结果:颅底凹陷主要由CVJ发育异常引起,常伴有先天性异常。还有一种是后天的,是由骨骼软化引起的,比如风湿性关节炎。可分为ⅰ型(寰枢关节脱位)和ⅱ型(无寰枢关节脱位)颅底内陷。临床症状可能是由于脑干压迫或颈脊髓压迫和不稳定。虽然提出了许多放射学测量方法,但最可靠的是麦克雷线、张伯伦线和布加德角。结论:颅底凹陷的诊断应通过颅颈正中矢状面x线、ct或MRI检查。有两种类型的基底动脉内陷:I型基底动脉内陷与不稳定有关,治疗可侧重于稳定。然而,II型颅底凹陷可能需要减压手术。
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来源期刊
Spine
Spine 医学-临床神经学
CiteScore
5.90
自引率
6.70%
发文量
361
审稿时长
6.0 months
期刊介绍: Lippincott Williams & Wilkins is a leading international publisher of professional health information for physicians, nurses, specialized clinicians and students. For a complete listing of titles currently published by Lippincott Williams & Wilkins and detailed information about print, online, and other offerings, please visit the LWW Online Store. Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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