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Effect of upright position on tonsillar level in adolescent idiopathic scoliosis

  • Magnetic Resonance
  • Published:
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Abstract

Purpose

The aim of this study was to investigate the effect of an upright position on cerebellar tonsillar level in patients with adolescent idiopathic scoliosis (AIS).

Methods

Twenty-five patients with clinically diagnosed AIS and 18 normal controls were examined in both supine and upright positions using 0.25T MRI. The position of the inferior cerebellar tonsil tip relative to a reference line connecting the basion to the opisthion (BO line) was measured in millimetres.

Results

None of the 18 normal control subjects had cerebellar tonsillar descent below the BO line in either supine or the upright position. Forty-eight percent of AIS patients had tonsillar descent in the upright position, compared to 28 % in the supine position. In the upright position, cerebellar tonsillar position was lower in AIS patients than in normal subjects (mean −0.7 ± 1.5 vs. +2.1 ± 1.7, p < 0.00001). AIS patients also had a large degree of tonsillar excursion between upright and supine positions compared to normal subjects (mean −1.9 ± 2.3 vs. −0.1 ± 0.2, p < 0.00001).

Conclusions

When considering the theoretical likelihood that a low tonsillar position may affect spinal cord function, one should bear in mind that tonsillar descent in AIS is significantly greater in the upright position.

Key Points

• AIS patients exhibited greater cerebellar tonsillar descent in upright than supine position.

• Cerebellar tonsillar position was lower in AIS patients than normal subjects.

• AIS patients exhibited greater tonsillar excursion between supine and upright positions.

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Acknowledgments

The scientific guarantor of this publication is Ryan Ka Lok Lee. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, case–control study, performed at one institution.

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Authors and Affiliations

  1. Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong, The Chinese University of Hong Kong, Shatin, Hong Kong

    Ryan K. L. Lee, James F. Griffith, Joyce H. Y. Leung & Winnie C. W. Chu

  2. Department of Orthopedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong

    T. P. Lam, Bobby K. W. Ng & Jack C. Y. Cheng

  3. Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, SAR, China

    James F. Griffith

Authors
  1. Ryan K. L. Lee
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  2. James F. Griffith
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  3. Joyce H. Y. Leung
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  4. Winnie C. W. Chu
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  5. T. P. Lam
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  6. Bobby K. W. Ng
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  7. Jack C. Y. Cheng
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Corresponding author

Correspondence to James F. Griffith.

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Lee, R.K.L., Griffith, J.F., Leung, J.H.Y. et al. Effect of upright position on tonsillar level in adolescent idiopathic scoliosis. Eur Radiol 25, 2397–2402 (2015). https://doi.org/10.1007/s00330-015-3597-3

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  • DOI: https://doi.org/10.1007/s00330-015-3597-3

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