Magnetic resonance imaging effectiveness in adolescent idiopathic scoliosis

Oliveira, Rafael Garcia de; Araujo, Alex Oliveira de; Gomes, Cícero Ricardo

doi:10.1007/s43390-020-00205-2

Cited by 6 publications

(8 citation statements)

References 20 publications

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“…[1,8,12] According to the different studies, the incidence of neural axis anomalies in AIS patients ranges from 2 to 26%. [3,6,7] According to Dewan et al, [8] 114 (14%) of 811 scoliosis patients showed aberrant neural axis, with no significant link with a left-sided thoracic curve, double thoracic curve, male gender, or scoliosis diagnosis before the age of 10. Ameri et al [9] reported that 9.9% of 271 patients had neural axis abnormalities and that they were directly related to the male gender and early-onset idiopathic scoliosis disease.…”

Section: Discussionmentioning

confidence: 99%

“…In individuals with syringomyelia; however, neurological problems have been reported after surgical scoliosis correction without decompression. [3] Therefore, some authors hypothesize that the routine use of pre-operative whole-spine MRI to determine neural axis abnormalities in patients with AIS can be critical. [5,9] However, some surgeons suggest that pre-operative whole-spine MRI and decompression are not indicated in the absence of neurological abnormalities.…”

Section: Discussionmentioning

confidence: 99%

“…[1,5] Prominent recent papers estimate that anywhere from 2 to 26% of AIS patients have associated neural axis abnormalities. [3,6,7] Neurological abnormalities are asymptomatic for the most part and are subclinical, as pointed out by Dewan et al [8] Nevertheless, these abnormalities are clinically pertinent to the surgical correction of scoliosis. The use of standard pre-operative magnetic resonance imaging (MRI) to investigate these anomalies in AIS patients is still debatable.…”

mentioning

confidence: 99%

“…The condition's idiopathic nature makes the physical examination, clinical history, and -most importantly -the radiological diagnosis modality of choice particularly important. [3] Many ongoing debates are regarding the risk factors and neural axis abnormalities associated with AIS. Neurological abnormalities associated with AIS have been documented since the early 1940s.…”

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confidence: 99%

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Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study

Assiri

Eissa

Konbaz

et al. 2022

JMSR

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Objectives: Adolescent idiopathic scoliosis (AIS) has been rigorously discussed in academia for the better part of a century, primarily due to its nuanced and complex management. To date, there are no universal criteria for its management. The use of pre-operative magnetic resonance imaging (MRI) in all patients with AIS is still debatable. We aimed to determine the necessity of using pre-operative routine MRI assessment in all patients treated for AIS. Methods: A retrospective and descriptive medical chart review study was done. We examined AIS patients diagnosed between 10 and 18 years of age who underwent surgical treatment between 2016 and 2020. A full medical history and a complete spine clinical examination were performed on all patients. Results: Of 267 consecutive patients with verified AIS who underwent surgical correction, 176 were included in the analysis. All patients had normal pre-operative physical and neurological examinations. There were 138 (78%) female and 38 (22%) male patients. MRI findings of neural axis abnormalities were observed in eight of 176 patients (4.54%). Conclusion: In our study, the incidence of abnormalities in the neural axis was low and no additional neurosurgical procedures were performed. This could be due to our strict inclusion criteria. However, we cannot establish a recommendation regarding the routine use of pre-operative MRI. A meta-analysis of the currently available data may provide a better assessment in terms of cost-effectiveness and pave the way for the implementation of guidelines for screening protocols.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study

Assiri

Eissa

Konbaz

et al. 2022

JMSR

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“…In general, tomographic imaging techniques are not indicated in adolescent idiopathic scoliosis (11 to 17 years), the most common type, except when painful or unusual symptoms are present, such as headache or neurological involvement (130). Presurgical screening in these patients has demonstrated a prevalence of neurological axis abnormalities of 7.9-12.6% (131)(132)(133). Bony causes of scoliosis include benign tumors such as osteoid osteoma or osteoblastoma (134) (Figure 24).…”

Section: Alterations In the Spinal Curvaturementioning

confidence: 99%

The value of magnetic resonance imaging and computed tomography in the study of spinal disorders

Santiago¹,

Ramos‐Bossini²,

Wáng³

et al. 2022

Quant Imaging Med Surg

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Computed tomography (CT) and magnetic resonance imaging (MRI) have replaced conventional radiography in the study of many spinal conditions, it is essential to know when these techniques are indicated instead of or as complementary tests to radiography, which findings can be expected in different clinical settings, and their significance in the diagnosis of different spinal conditions. Proper use of CT and MRI in spinal disorders may facilitate diagnosis and management of spinal conditions. An adequate clinical approach, a good understanding of the pathological manifestations demonstrated by these imaging techniques and a comprehensive report based on a universally accepted nomenclature represent the indispensable tools to improve the diagnostic approach and the decision-making process in patients with spinal pain. Several guidelines are available to assist clinicians in ordering appropriate imaging techniques to achieve an accurate diagnosis and to ensure appropriate medical care that meets the efficacy and safety needs of patients. This article reviews the clinical indications of CT and MRI in different pathologic conditions affecting the spine, including congenital, traumatic, degenerative, inflammatory, infectious and tumor disorders, as well as their main imaging features. It is intended to be a pictorial guide to clinicians involved in the diagnosis and treatment of spinal disorders.

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Entire-spine Magnetic Resonance Imaging Findings and Costs in Children With Presumed Adolescent Idiopathic Scoliosis

Johnson

Gohel

Mitchell

et al. 2021

Journal of Pediatric Orthopaedics

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Background: Patients with adolescent idiopathic scoliosis (AIS) are commonly monitored for curve progression with spinal radiographs; however, the utility of magnetic resonance imaging (MRI) screening is unclear. The purpose of this study was to assess the findings of screening MRI for patients with a nonsurgical curve size ordered during routine clinical care and compare them with MRI ordered for patients with large curves as part of preoperative screening. Methods: All consecutive patients with presumed AIS who underwent entire-spine MRI with a presumed diagnosis of idiopathic scoliosis at a single institution between 2017 and 2019 were retrospectively reviewed. Patients were stratified based on MRI indication into the following groups: preoperative evaluation, pain, neurological symptoms, abnormal radiographic curve appearance, rapidly progressive curve, and other. Neural axis abnormalities recorded included concern for tethered spinal cord, syringomyelia, and Chiari malformation. The MRI findings of preoperative patients with large curves were compared with all other patients. The number needed to diagnose (NND) a neurological finding was calculated in patients whose MRIs were ordered during routine clinical care. The amount charged for each patient undergoing entire-spine MRI was determined by review of our institution's Financial Decision Support system. Results: There were 344 patients included in this study with 214 (62%) MRIs performed for preoperative evaluation. Although MRI abnormalities were found in 49% of patients, only 7.0% (24/ 344) demonstrated neural axis abnormalities with no difference between preoperative and other indications (P = 0.37). For patients with nonsurgical curves undergoing MRI due to a complaint of back pain (n = 28), there were no neural axis abnormalities, and a lower rate of disk herniation/degenerative changes detected compared with preoperative MRI (3.6% vs. 18%, P = 0.06). Among the 15 patients undergoing MRI for a neurological concern, 1 had a neural axis abnormality that required surgical detethering. The NND for MRI to detect a neural axis abnormality that potentially required neurosurgical intervention in nonpreoperative patients with a neurological concern was 34.4. The average cost for MRI

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Magnetic resonance imaging effectiveness in adolescent idiopathic scoliosis

Cited by 6 publications

References 20 publications

Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study

Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study

The value of magnetic resonance imaging and computed tomography in the study of spinal disorders

Entire-spine Magnetic Resonance Imaging Findings and Costs in Children With Presumed Adolescent Idiopathic Scoliosis

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