The incidence and interrelationship of concomitant anomalies in congenital scoliosis

Abstract

Maternal diabetes mellitus, hypoxia, vitamin deficiencies, and anticonvulsant medication use have been associated with CS (9). Development of the spinal cord and organs of mesodermal origin is closely related to development of the vertebral column (1). As a result, CS is often associated with anomalies of the spinal cord, cardiovascular system, and genitourinary system (12). Previously, the incidences of intraspinal and other organ system pathologies associated with CS were reported █ INTRODUCTION C ongenital scoliosis (CS) is characterized by a spinal curvature secondary to congenital vertebral malformations. Deformity of the spine secondary to failure of normal vertebral development at 4-6 weeks of gestation is an accepted criterion (16). A multifactorial etiology of scoliosis is accepted (2,10,15). The genetic factors associated with CS remain largely unknown (8). However, environmental factors are proven to have a strong relationship with CS (1,8,9,14,23). AIM: To report the incidence and interrelationship of concomitant anomalies in congenital scoliosis (CS) patients. MATERIAL and METHODS: Whole-spine computed tomography and magnetic resonance imaging (MRI) examination, echocardiography, and renal ultrasonography (USG) evaluations of 231 patients with CS were reviewed. Additionally, intraspinal pathologies and structural cardiac and renal anomalies were recorded. RESULTS: The incidence of intraspinal pathology was 53.7%. Echocardiography was performed in 140 of 231 patients, and congenital heart disease was detected in 38 patients. Renal USG was performed in 133 of 231 patients, and a renal disease was detected in 37 patients. In 133 patients, spinal MRI, echocardiography, and renal USG were performed. In 22 of 67 (32.8%) patients with an intraspinal anomaly, an additional cardiac anomaly was detected. In 27 of 67 (40.3%) patients with an intraspinal anomaly, an additional renal anomaly was detected. In 47.3% of patients with a cardiac anomaly, an additional renal anomaly was detected. In 15 of 133 patients (11.2%) intraspinal, cardiac, and renal anomalies were identified. CONCLUSION: Surgeons should evaluate additional anomalies in CS if patients report having a congenital anomaly. Because cardiac and renal anomalies increase intra-and postoperative complication risks, a careful and comprehensive preoperative evaluation is needed.

Incidence of intraspinal abnormalities in congenital scoliosis: a systematic review and meta-analysis

“…Faloon et al [31] concluded that there was no difference between males and females in the proportion of adolescent idiopathic scoliosis cases with neuraxial abnormalities. Sevencan et al [16] reported that in CS patients, females had a significantly higher incidence of intraspinal abnormalities than males. In the present study, we concluded that the incidence of intraspinal abnormalities in males and females were 30% and 41%, respectively.…”

“…1. A total of 10 studies published from 2001 to 2019 described intraspinal abnormalities in CS patients undergoing MRI examinations [1,16,[19][20][21][22][23][24][25]28]. The basic characteristics of the included studies are shown in Table 1.…”

“…As a meta-analysis, all raw data of this study are extracted from ten included studies. The datasets supporting the conclusions of this article are available in the ten included studies [1,16,[19][20][21][22][23][24][25]28].…”

“…In 1984, McMaster found intraspinal abnormalities in 18% of 251 patients with myelography [15]. Currently, magnetic resonance imaging (MRI) is considered more sensitive and noninvasive in detecting intraspinal abnormalities [16][17][18]. Its use has been suggested to comprehensively evaluate CS patients before surgical interventions are performed [19,20].…”

“…Its use has been suggested to comprehensively evaluate CS patients before surgical interventions are performed [19,20]. However, the incidence of intraspinal abnormalities detected by MRI is highly variable, ranging from 21.8 to 53.7% [1,16,[19][20][21][22][23][24][25][26][27][28]. In addition, it is not known whether sex and CS types affect the incidence of intraspinal abnormalities in patients with CS.…”