Intraspinal anomalies in early onset scoliosis: Current concepts

Singrakhia, Manoj; Malewar, Nikhil; Jangle, Ajit

doi:10.4103/jpn.jpn_100_17

Cited by 7 publications

(5 citation statements)

References 71 publications

(88 reference statements)

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“…The overall incidence of intraspinal abnormalities reported in patients with congenital spinal deformity is 37%, ranging from 21% to 43%. [1][2][3][4][5][16][17][18] Similarly, Williams et al 11 reported that patients with Congenital-EOS had higher odds of abnormal MRI findings than other EOS categories. Specifically, they found a 24% prevalence of overall abnormal findings in the general EOS population with 35% in the congenital group of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Some studies have analyzed the correlation between Congenital-EOS and MRI underlying pathology. The overall incidence of intraspinal abnormalities reported in patients with congenital spinal deformity is 37%, ranging from 21% to 43% 1–5,16–18 . Similarly, Williams et al 11 reported that patients with Congenital-EOS had higher odds of abnormal MRI findings than other EOS categories.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study

Ramirez,

Deliz-Jimenez,

Torres-Lugo

et al. 2024

Journal of Pediatric Orthopaedics

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Background: Back pain, as a clinical marker in scoliosis, has been associated with underlying pathology for many years, warranting further magnetic resonance imaging (MRI). Failures of segmentation, mixed defects, female gender, rib anomalies, congenital thoracic anomalies, and neurocutaneous markers are known risk factors for abnormal MRI pathology findings in patients with congenital early-onset scoliosis (Congenital-EOS). Yet, back pain has not been evaluated as a risk factor for underlying MRI pathology in patients with Congenital-EOS. This study aimed to assess back pain as a risk factor for underlying pathology in Congenital-EOS using MRI as a diagnostic tool. Methods: A retrospective database review from the Pediatric Spine Study Group (PSSG) of all patients with Congenital-EOS who reported a back pain complaint, and underwent a spinal MRI study before surgical intervention was performed. Patients were divided into those with an underlying MRI pathology and those without. Demographics were compared between groups. Results: From a total of 2355 patients with Congenital-EOS registered in PSSG, 107 patients reported a back pain complaint, with only 42 patients fulfilling the inclusion criteria (being evaluated with an MRI study). Overall group mean age was 8.1±4.5 years, with 25 of the 42 patients (60%) being females. Twenty-four of 42 patients (57%) had a comorbidity reported such as cardiac problems, musculoskeletal complaints, neurological deficits/myelopathy, gastrointestinal symptoms, developmental delay, respiratory problems, craniofacial abnormalities, and chromosomal conditions. An underlying MRI pathology was found in 21 of 42 patients with Congenital-EOS (50%) with back pain. The underlying MRI pathologies found were tethered spinal cord, spinal canal stenosis, syringomyelia, Arnold-Chiari malformation, and arachnoid cyst. Conclusions: Abnormal MRI findings are common in patients with Congenital-EOS who report back pain. Gender, age, major coronal curve angle, thoracic or lumbar predominance deformity, and comorbidities type or amount were not associated with abnormal MRI findings. Level of Evidence: Level II—Prognostic study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study

Ramirez,

Deliz-Jimenez,

Torres-Lugo

et al. 2024

Journal of Pediatric Orthopaedics

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“…[ 6 , 24 , 25 ]Formatting... please wait Similarly, in cases of congenital scoliosis, early-onset scoliotic deformity may occur in 25–80% of patients with DM, TC, or SM, often with Chiari malformation. [ 16 , 22 ]…”

Section: Discussionmentioning

confidence: 99%

Surgical correction of pediatric spinal deformities with coexisting intraspinal pathology: A case report and literature review

Li¹,

Anderson²,

Nockels³

2021

Surgical Neurology International

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Background: Surgical correction of spinal deformities with coexisting intraspinal pathology (SDCIP) requires special consideration to minimize risks of further injury to an already abnormal spinal cord. However, there is a paucity of literature on this topic. Here, the authors present a pediatric patient with a residual pilocytic astrocytoma and syringomyelia who underwent surgical correction of progressive postlaminectomy kyphoscoliosis. Techniques employed are compared to those in the literature to compile a set of guidelines for surgical correction of SDCIP. Methods: A systematic MEDLINE search was conducted using the following keywords; “pediatric,” “spinal tumor resection,” “deformity correction,” “postlaminectomy,” “scoliosis correction,” “intraspinal pathology,” “tethered cord,” “syringomyelia,” or “diastematomyelia.” Recommendations for surgical technique for pediatric SDCIP correction were reviewed. Results: The presented case demonstrates recommendations that primarily compressive forces on the convexity of the coronal curve should be used when performing in situ correction of SDCIP. Undercorrection is favored to minimize risks of traction on the abnormal spinal cord. The literature yielded 13 articles describing various intraoperative techniques. Notably, seven articles described use of compressive forces on the convex side of the deformity as the primary mode of correction, while only five articles provided recommendations on how to safely and effectively surgically correct SDCIP. Conclusion: The authors demonstrated with their case analysis and literature review that there are no clear current guidelines regarding the safe and effective techniques for in situ correction and fusion for the management of pediatric SDCIP.

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“…Surgical intervention is pivotal in managing diastematomyelia, addressing neurological symptoms, preventing further complications, and improving the patient's overall quality of life [5]. Laminectomy and correction of the split spinal cord, as performed in this case, represent established surgical techniques for managing this complex anomaly [6]. This case report aims to contribute to the existing literature on the clinical presentation, diagnostic approach, and successful surgical management of type 2 diastematomyelia with spina bifida in a pediatric patient.…”

Section: Introductionmentioning

confidence: 93%

A Case of Type 2 Diastematomyelia With Spina Bifida in a Pediatric Female Patient

Bothara,

Parihar

2024

Cureus

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This case report presents the clinical and radiological findings of a seven-year-old female with type 2 diastematomyelia and spina bifida, emphasizing the complexity of congenital spinal anomalies in pediatric patients. The patient presented with a two-month history of lower back pain, prompting diagnostic investigations. Radiographic examination revealed spina bifida at the L3-L5 levels, subsequently confirmed by magnetic resonance imaging (MRI), which disclosed bifid spinous processes, an absent posterior arch, and a split spinal cord terminating at the L3-L4 disc levels. The Vancouver classification system facilitated a standardized characterization of congenital spinal anomalies. The multidisciplinary approach involving orthopedic and neurosurgical specialists led to a conclusive diagnosis of type 2 diastematomyelia with simple spinal dysraphism. Surgical intervention, encompassing laminectomy and correction of the split spinal cord, was successfully performed, resulting in the stabilization of the patient. This case underscores the importance of early diagnosis, advanced imaging modalities, and collaborative management in addressing rare congenital spinal anomalies. The discussion delves into the clinical implications, diagnostic challenges, and the pivotal role of surgical intervention. Insights from this case contribute to the existing literature, guiding healthcare professionals in understanding and managing similar cases with potential implications for future research and treatment strategies.

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Intraspinal anomalies in early onset scoliosis: Current concepts

Cited by 7 publications

References 71 publications

Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study

Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study

Surgical correction of pediatric spinal deformities with coexisting intraspinal pathology: A case report and literature review

A Case of Type 2 Diastematomyelia With Spina Bifida in a Pediatric Female Patient

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