The Role of Routine Preoperative Magnetic Resonance Imaging in Idiopathic Scoliosis: A Ten Years Review

Abstract

Study DesignProspective study.PurposeTo determine the role of routine preoperative magnetic resonance imaging (MRI) to detect the incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis.Overview of LiteratureThe incidence and risk factors for intraspinal anomalies in patients with idiopathic scoliosis are controversial, and the indications for preoperative MRI in these patients vary among centers.MethodsInformation on patients with idiopathic scoliosis who were surgical candidates over 10 years (age at presentation, sex, magnitude and apex of major curve, intraspinal anomalies detected by MRI, and neurological examination results) were recorded, the patients were grouped according to the intraspinal anomaly, and the data were analyzed.ResultsOf the 271 patients with idiopathic scoliosis, 27 had neuroaxial abnormalities (9.9%). Of these 27 patients, 14 (52%) underwent a neurosurgical procedure. Significant differences were observed in the frequency of early disease onset and male sex (p<0.05) between the group of patients with neuroaxial abnormalities on preoperative MRI and those who did not have a cord anomaly. No difference was detected in the magnitude or direction of the curve.ConclusionsNeuroaxial abnormalities in patients with idiopathic scoliosis and a normal neurological examination were highly frequent (9.9%). Missing these abnormalities before surgery could inflict catastrophic postoperative complications. The incidence of neuroaxial abnormalities was higher in male patients and in those with early onset disease. Thus, MRI is essential for all patients with idiopathic scoliosis who require medical intervention.

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

“…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.…”

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

“…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 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. The risk factors identified in this study can be divided into three categories, namely, general, imaging, and neurologic characteristics; a total of 12 clinical indicators were included in the correlation analysis.…”

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

“…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. The risk factors identified in this study can be divided into three categories, namely, general, imaging, and neurologic characteristics; a total of 12 clinical indicators were included in the correlation analysis.…”