Prevalence and risk factors for neural axis anomalies in idiopathic scoliosis: a systematic review

BMC Musculoskelet Disord

et al. 2020

Background: Approximately 80% of adolescent scoliosis cases are idiopathic, and some non-idiopathic scoliosis cases caused by spinal cord abnormalities are misdiagnosed as idiopathic scoliosis. This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities, explored the feasibility of whole-spine MRI, and provided a theoretical basis for the routine diagnosis and treatment of adolescent idiopathic scoliosis. Method: The clinical data of adolescent scoliosis patients who were admitted to Shanghai Tongren Hospital and Shanghai Changhai Hospital between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. Sex, age, main curvature angle, main curvature direction, kyphosis angle, scoliosis type, coronal plane balance, sagittal plane balance, abdominal wall reflex, sensory abnormality, ankle clonus and tendon reflexes were compared between the two groups. Student's t test was used to evaluate the differences in the continuous variables, and the chi-square test was used to evaluate the differences in the categorical variables. Fisher's exact test was applied to detect the difference in the rate of intraspinal anomalies between the groups. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities.

“…According to previous studies and this study, the incidence of intramedullary abnormalities in patients initially diagnosed with idiopathic scoliosis is approximately 6.3 to 9.9% [4]. As 90.1 to 93.7% of patients have idiopathic scoliosis, a whole-spine MRI to determine whether there is an intramedullary abnormality could be considered a waste of resources.…”

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: proposal for a selective whole-spine MRI examination scheme

BMC Musculoskelet Disord

et al. 2020

“…According to previous studies and this study, the incidence of intramedullary abnormalities in patients initially diagnosed with idiopathic scoliosis is approximately 6.3% to 9.9% 4 There are not many relevant studies searched on pubmed. Choon et al 9 suggested that males and patients with increased thoracic kyphosis are risk factor.Zhang et al 10 considered that aged less than 10 years, being male or having left thoracic or right lumbar curve are risk factor.Beyond that long curve span, apex at thoracolumbar spine and hyperthoracic kyphosis and so on are also risk factor 3,[6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] .This study includes the second largest research sample to date.…”

Section: Discussionmentioning

confidence: 79%

An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: Proposal for a selective whole-spine MRI examination scheme

et al. 2020

Preprint

Objective This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities(IA). Method The clinical data of adolescent patients between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. 12 data were compared between the two groups. Student’s t test and the chi-square test were used to evaluate the differences in the continuous variables and categorical variables. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities. Result A total of 714 adolescent patients with scoliosis with a mean age of 13.5 (10-18 years) were included in the study, and IA were found in 68 (9.5%) patients. There were statistically significant differences in the incidence rates of intramedullary abnormalities between males and females, left and right thoracic curvatures, angular scoliosis and smooth scoliosis, and abnormal abdominal wall reflex and ankle clonus (P<0.01). Logistic regression showed that the ratios for sex, scoliosis direction, scoliosis type, abdominal wall reflex and ankle clonus were 2.987, 3.493, 4.823, 3.94 and 8.083, respectively. The ROC curve showed a sensitivity of 66.18% and a specificity of 89.01%(0.5519). Conclusion The incidence of scoliosis caused by IA was approximately 9.5%.The risk factors associated with AS caused by abnormal IA included the male sex, thoracic scoliosis on the left side, a sharp curvature of the spine, an abnormal abdominal wall reflex and ankle clonus.

“…In recent years, several articles have suggested that MRI examination of scoliosis patients is necessary. Studies have found that the incidence of scoliosis with spinal cord abnormalities is 6.3% to 9.9% 3,4 . However, considering the current medical situation in China, it is particularly difficult for all patients with scoliosis to undergo an MRI examination of the whole spine.…”

Section: Introductionmentioning

confidence: 99%

An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: Proposal for a selective whole-spine MRI examination scheme

et al. 2019

Preprint

Background This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities, explored the feasibility of whole-spine MRI, and provided a theoretical basis for the routine diagnosis and treatment of adolescent idiopathic scoliosis. Method The clinical data of adolescent scoliosis patients who were admitted to Shanghai Tongren Hospital and Shanghai Changhai Hospital between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. Sex, age, main curvature angle, main curvature direction, kyphosis angle, scoliosis type, coronal plane balance, sagittal plane balance, abdominal wall reflex, sensory abnormality, ankle clonus and tendon reflexes were compared between the two groups. Student’s t test was used to evaluate the differences in the continuous variables, and the chi-square test was used to evaluate the differences in the categorical variables. Fisher’s exact test was applied to detect the difference in the rate of intraspinal anomalies between the groups. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities. Result A total of 714 adolescent scoliosis patients with a mean age of 13.5 (10-18 years) were included in the study, and intramedullary abnormalities were found in 68 (9.5%) patients. There were statistically significant differences in the incidence rates of intramedullary abnormalities between males and females, left and right thoracic curvatures, angular scoliosis and smooth scoliosis, and abnormal abdominal wall reflex and ankle clonus (P<0.01). Logistic regression showed that the ratios for sex, scoliosis direction, scoliosis type, abdominal wall reflex and ankle clonus were 2.987, 3.493, 4.823, 3.94 and 8.083, respectively. The ROC curve showed a sensitivity of 66.18% and a specificity of 89.01%, and the Youden index corresponding to the optimal critical point was 0.5519. Conclusion Risk factors associated with adolescent scoliosis caused by abnormal intramedullary abnormalities included male sex, thoracic scoliosis on the left side, sharp curvature of the spine, abnormal abdominal wall reflex and ankle clonus. These clinical indicators suggest that there is a high-risk adolescent scoliosis population who should undergo whole-spinal MRI preoperatively to rule out intramedullary abnormalities.