Magnetic resonance imaging evaluation of patients with idiopathic scoliosis: a prospective study of four hundred seventy-two outpatients.
METHODS
A prospective study of magnetic resonance imaging findings in outpatients with idiopathic scoliosis.


OBJECTIVE
The purpose of this study was to determine the prevalence of neural axis abnormalities in outpatients with scoliosis and to analyze the characteristics of patients who had such abnormalities.


BACKGROUND
In previous studies, neural axis abnormalities were found in 2.9% to 37% of patients with idiopathic scoliosis. The current guidelines for MRI screening in scoliosis are valuable, and the proposed indications for performing MRI in the literature include early onset, atypical curvature, double thoracic curve (King type-5), rapid progression, male gender, and abnormal neurologic findings.


METHODS
A total of 472 outpatients with a primary diagnosis of idiopathic scoliosis were examined for neural axis abnormalities by magnetic resonance imaging. Logistic regression was used to determine significant predictors of neural axis abnormalities on MRI.


RESULTS
The incidence of neural axis abnormalities on MRI was 3.8% (18 of 472 patients). Among the 18 patients, 6 had a Chiari I malformation alone, 10 had a Chiari I malformation combined with syringomyelia, and 2 had a syringomyelia without Chiari I malformation. Male gender, patients younger than 11 years old, and abnormal superficial abdominal reflexes were significantly associated with the detection of neural axis abnormalities on MRI.


CONCLUSIONS
We recommend routine use of MRI in male patients, younger than 11 years old, and abnormal superficial abdominal reflexes. Even if a patient has no specific indications for MRI, we recommend its routine use in preoperative planning.
Nakahara
Daishi
D
Department of Orthopaedic Surgery, Juntendo University, Tokyo, Japan.
Yonezawa
Ikuho
I
Kobanawa
Koji
K
Sakoda
Junta
J
Nojiri
Hidetoshi
H
Kamano
Shunya
S
Okuda
Takatoshi
T
Kurosawa
Hisashi
H
D000553:Ambulatory Care / Q000379:methods*; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011446:Prospective Studies; D012600:Scoliosis / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology*; D013595:Syringomyelia / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology