title: Hyperkyphosis as an indicator of syringomyelia in idiopathic scoliosis: a case report.
abstract: METHODS
  A case of thoracic hyperkyphosis is reported as an atypical presentation of otherwise typical adolescent idiopathic scoliosis that showed a large syringomyelia on magnetic resonance imaging. OBJECTIVE To review atypical curve patterns that indicate the need for more intensive preoperative workup including a magnetic resonance imaging scan.
  
  
  BACKGROUND
  The literature on atypical curve patterns of adolescent "non-idiopathic" scoliosis is reviewed. No report in the literature describes patients with an idiopathic coronal plane and thoracic hyperkyphosis as an atypical feature found to have a large syringomyelia and Chiari I malformation on magnetic resonance imaging examination.
  
  
  METHODS
  The clinical and radiographic features associated with thoracic hyperkyphosis and juvenile and adolescent scoliosis with syringomyelia are presented.
  
  
  RESULTS
  The neurosurgical treatment of the syringomyelia subsequently led to a potentially safer spinal fusion. The patient tolerated the procedures well and at this writing has remained asymptomatic during 3 years of follow-up evaluation.
  
  
  CONCLUSIONS
  The reported case adds to the hyperkyphosis literature category of unusual spinal deformities seen in scoliosis associated with syringomyelia and should further help to categorize adolescent idiopathic scoliosis as a diagnosis of exclusion.
authors.affiliation: Department of Orthopaedic Surgery, University of Kansas School of Medicine, Wichita, Kansas, USA.
authors.forename: Camden
authors.initials: C
authors.lastname: Whitaker
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
authors.forename: Lawrence G
authors.initials: LG
authors.lastname: Lenke
mesh_terms: D000208:Acute Disease; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures; D011859:Radiography; D012600:Scoliosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013123:Spinal Fusion; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome