A Prognostic Model for the Presence of Neurogenic Lesions in Atypical Idiopathic Scoliosis

Morcuende, José A.; Dolan, Lori A.; Vazquez, Javier D.; Jirasirakul, Amnuay; Weinstein, Stuart L.

doi:10.1097/01.brs.0000105526.65485.92

Cited by 40 publications

(24 citation statements)

References 38 publications

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“…Scoliosis associated with chronic, disabling pain or pain that awakens the patient at night has been associated with tumors in the spine and spinal cord and warrants further investigation. Morcuende et al [35] reported 13 scoliosis patients who underwent MRI because of pain. None of them had an abnormal MRI, and none of their patients who had syringomyelia and Arnold-Chiari type I malformations complained of headache or neck pain.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study

2014

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BackgroundIn previous studies, many indicator factors have been proposed to select patients who need an MRI screening of the spinal canal. In current study, the clinical and radiologic factors including coronal parameters of the curve were evaluated to find out which indicator is more important.MethodsA prospective study included 143 consecutive patients with the diagnosis of adolescent idiopathic scoliosis who were treated between 2010 and 2013 at our spinal clinics. Only patients with normal or subtle neurologic findings were included. All patients were evaluated by a total spine MRI protocol for examination of neuroaxial abnormalities. Known indicators and also coronal shift were analysed in all patients with or without abnormal MRI.ResultsThe incidence of neuroaxial abnormalities was 11.9% (17 of 143); only 5 patients (3.5%) were operated to treat their neuroaxial problem. The significant indicators of the abnormalities in our patients were: younger age at onset, asymmetric superficial abdominal reflex and, coronal shift more than 15 mm (P = 0.03). Some previously known indicators like atypical curves, male gender, double curves and absence of thoracic lordosis were not different between two groups of the patients.ConclusionsA total spine MRI is recommended at presentation in patients with younger age, abnormal neurologic findings and severe coronal shift.

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Section: Discussionmentioning

confidence: 99%

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study

2014

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“…Others suggest that the clinical predictors of intraspinal lesions include sagittal plane malalignment of spinal contour [2,11,12], early-onset scoliosis [1,3,11,12], severe curves in immature individuals [14,15], double curves [11], pain [1,12] and male gender [16]. However, no specific indicator appears reliable or reproducible in its predictive value.…”

Section: Discussionmentioning

confidence: 99%

The use of routine preoperative magnetic resonance imaging in identifying intraspinal anomalies in patients with idiopathic scoliosis: a 10-year review

et al. 2012

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Purpose This study sought to quantify the frequency of previously unidentified spinal cord anomalies identified by routine preoperative magnetic resonance imaging (MRI), in patients planned for surgical scoliosis correction. Methods Our study group comprised 206 patients with idiopathic scoliosis who underwent deformity correction from 1998 to 2008. Clinical records of all the patients were retrospectively reviewed to ascertain the proportion having a neural abnormality on preoperative MRI scan. Results Twenty of 206 patients (9.7 %) were diagnosed with an unexpected intraspinal anomaly on routine preoperative MRI. In all cases, a neurosurgical opinion was sought prior to further intervention. Of the 20 patients, 11 underwent a neurosurgical procedure (de-tethering of cord, decompression of Chiari, decompression of syrinx). There was no statistically significant difference between the group of patients who had intrinsic spinal cord anomalies on preoperative MRI and those did not have a cord abnormality with regard to age at presentation, gender, side of dominant curve and degree of curve (p \ 0.05). Conclusion The high frequency of spinal cord abnormalities unidentified by preoperative neurological examination, and the frequent need for subsequent neurosurgical intervention, suggests that MRI assessment prior to deformity correction is important in the management of idiopathic scoliosis.

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“…Scoliosis with early age of onset, atypical shape (a single left thoracic or thoracolumbar curve), a rapidly progressive curve (>1º per month), a severe curve (>45º) despite immaturity, scoliosis with local pain, and male gender-all indicate a possible intraspinal pathology causing idiopathic scoliosis. 11,14,15 Patients with one or more of the above features should undergo MRI to rule out neural axis abnormalities, although in several studies there was no correlation between some of these features and intraspinal pathology.…”

Section: Discussionmentioning

confidence: 99%

Curve Length, Curve Form, and Location of Lower-End Vertebra as a Means of Identifying the Type of Scoliosis

Abul-Kasim

Ohlin

2010

J Orthop Surg (Hong Kong)

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Purpose. To determine if the curve length, curve form, and location of the lower-end vertebra can identify the type of scoliosis. Methods. Standing posteroanterior and lateral radiographs of 78 women and 27 men with scoliosis aged 8 to 32 years were retrospectively analysed. Parameters measured were (1) the curve length (the number of vertebrae in the main curve), (2) the curve form (C-form, inverted C-form, or S-form), (3) the curve apex (the vertebral body at the apex of each curve), (4) the site of the scoliosis (thoracic, thoracolumbar, or lumbar), and (5) the location of the lower-end vertebra.

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A Prognostic Model for the Presence of Neurogenic Lesions in Atypical Idiopathic Scoliosis

Cited by 40 publications

References 38 publications

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study

Evaluation of coronal shift as an indicator of neuroaxial abnormalities in adolescent idiopathic scoliosis: a prospective study

The use of routine preoperative magnetic resonance imaging in identifying intraspinal anomalies in patients with idiopathic scoliosis: a 10-year review

Curve Length, Curve Form, and Location of Lower-End Vertebra as a Means of Identifying the Type of Scoliosis

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