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


CONCLUSIONS
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.
Department of Orthopaedics, Alder Hey Children's Hospital, Liverpool L12 2AP, UK. singhal.rohit75@gmail.com
Rohit
R
Singhal
Daniel C
DC
Perry
Seema
S
Prasad
Neil T
NT
Davidson
Colin E
CE
Bruce
D001139:Arnold-Chiari Malformation / Q000473:pathology* / Q000601:surgery; D002648:Child; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009460:Neurologic Examination; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012600:Scoliosis / Q000473:pathology* / Q000601:surgery; D013131:Spine / Q000002:abnormalities* / Q000473:pathology / Q000601:surgery; D013595:Syringomyelia / Q000473:pathology* / Q000601:surgery