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Grabb-Oakes measurement
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== Clinical significance == The pB-C2 line was first proposed by Grabb, et al. as a means of quantifying ventral brainstem compression in pediatric and young adult patients with [[Chiari malformation]].<ref name=":0">{{Cite journal | title = Ventral Brain Stem Compression in Pediatric and Young Adult Patients with Chiari I Malformations| url = https://academic.oup.com/neurosurgery/article/44/3/520/2859195|journal=Neurosurgery | date = 1999-03-01|issn=0148-396X | pages = 520–527|volume=44|issue=3|doi=10.1097/00006123-199903000-00050|language=en | first = W. Jerry | last = Oakes | first2 = Timothy B. | last2 = Mapstone | first3 = Paul A. | last3 = Grabb}}</ref> They found that in patients with pB-C2 lines less than 9mm, [[posterior fossa decompression surgery]] alone was sufficient to improve symptoms. However, following decompression surgery, patients with pB-C2 lines greater than 7mm (n=19) remained mildly symptomatic and those with measurements greater than 9mm (n=11), moderately symptomatic. In the latter group, treatment directed at improving the retroflexed odontoid was necessary.<ref name=":0" /> A second pediatrics study found that even among those with “normal” Grabb-Oakes measurements, higher measurements were correlated with a greater incidence of post-operative headache.<ref>{{Cite journal | last = Wellons | first = John C. | last2 = Tulipan | first2 = Noel | last3 = Tomycz | first3 = Luke | last4 = Shannon | first4 = Chevis N. | last5 = Day | first5 = Matthew A. | last6 = Dewan | first6 = Michael C. | last7 = Ladner | first7 = Travis R. | date = 2015-02-01 | title = Evaluating the relationship of the pB–C2 line to clinical outcomes in a 15-year single-center cohort of pediatric Chiari I malformation | url =https://thejns.org/view/journals/j-neurosurg-pediatr/15/2/article-p178.xml|journal=Journal of Neurosurgery: Pediatrics|language=en-US|volume=15|issue=2 | pages = 178–188|doi=10.3171/2014.9.PEDS14176|issn=1933-0715}}</ref> A consensus statement formed at the second International CSF Dynamics Symposium of the Chiari and Syringomyelia Foundation in 2013, proposed that a Grabb-Oakes measurement greater than 9mm, or in some cases, 8mm, could be seen as “potentially pathological.”<ref>{{Citation | title = Dr. Paolo Bolognese presents Chiari I Malformation, EDS, and Craniocervical Instability| url = https://www.youtube.com/watch?v=MsYDA3SXTkg|language=en|access-date=2019-09-02}}</ref><ref>{{Cite journal | last = Henderson | first = Fraser C. | date = 2016 | title=Cranio-cervical Instability in Patients with Hypermobility Connective Disorders| url = https://www.omicsonline.org/open-access/craniocervical-instability-in-patients-with-hypermobility-connective-disorders-2165-7939-1000299.php?aid=71754|journal=Journal of Spine|language=en|volume=05|issue=02|doi=10.4172/2165-7939.1000299|issn=2165-7939}}</ref>
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