Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study

Abstract

Objectives: Adolescent idiopathic scoliosis (AIS) has been rigorously discussed in academia for the better part of a century, primarily due to its nuanced and complex management. To date, there are no universal criteria for its management. The use of pre-operative magnetic resonance imaging (MRI) in all patients with AIS is still debatable. We aimed to determine the necessity of using pre-operative routine MRI assessment in all patients treated for AIS. Methods: A retrospective and descriptive medical chart review study was done. We examined AIS patients diagnosed between 10 and 18 years of age who underwent surgical treatment between 2016 and 2020. A full medical history and a complete spine clinical examination were performed on all patients. Results: Of 267 consecutive patients with verified AIS who underwent surgical correction, 176 were included in the analysis. All patients had normal pre-operative physical and neurological examinations. There were 138 (78%) female and 38 (22%) male patients. MRI findings of neural axis abnormalities were observed in eight of 176 patients (4.54%). Conclusion: In our study, the incidence of abnormalities in the neural axis was low and no additional neurosurgical procedures were performed. This could be due to our strict inclusion criteria. However, we cannot establish a recommendation regarding the routine use of pre-operative MRI. A meta-analysis of the currently available data may provide a better assessment in terms of cost-effectiveness and pave the way for the implementation of guidelines for screening protocols.