Vertebral, rib, and intraspinal anomalies in congenital scoliosis: a study on 202 Caucasians.
OBJECTIVE
To investigate vertebral, rib and intraspinal anomalies in patients with congenital scoliosis and their association with each other


METHODS
Clinical data and preoperative imaging studies of 202 Caucasians with congenital scoliosis operated on at an educational hospital within 6 years were reviewed for vertebral, rib, and intraspinal anomalies.


RESULTS
Rib and intraspinal anomalies were present in 57.4 and 21.8 % of patients, respectively. Most vertebral anomalies were located in the middle-lower thorax. Being the most common vertebral defect (53.5 %), failure of segmentation was significantly more common in males, whereas mixed defects were more frequent in females. Formation and mixed defects were associated with rib changes. Vertebral anomalies were more extensive in males than in females. The presence of multiple hemivertebrae was associated with rib deformity and intraspinal anomaly. Location of the vertebral anomalies varied with gender and rib involvement. Majority of rib changes were of simple type (70.7 %), significantly more common in males. Conversely, females had significantly more fused and bifid ribs. Two most common intraspinal anomalies were diastematomyelia (36.4 %) and syringomyelia (18.2 %). Intraspinal anomalies were located most frequently in the upper and lower thoracic regions. Syringomyelia and low conus were associated with female gender, and patients with rib changes suffered from intraspinal anomalies more frequently. No significant association was found between vertebral and intraspinal anomalies.


CONCLUSIONS
The incidences of rib and intraspinal anomalies were 57.4 and 21.8 % in surgical Caucasians with congenital scoliosis, respectively. Unlike vertebral and intraspinal anomalies, rib and intraspinal anomalies were significantly associated. Male gender and intraspinal anomaly were associated with some previously suggested risk factors of curve progression.
Bone and Joint Reconstruction Research Center, Shafa Orthopedic Teaching Hospital, Iran University of Medical Sciences, Tehran, Iran.
Hassan
H
Ghandhari
Hossein Vahid
HV
Tari
Ebrahim
E
Ameri
Mir Bahram
MB
Safari
Daniel Fadaei
DF
Fouladi
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D008297:Male; D009139:Musculoskeletal Abnormalities / Q000000981:diagnostic imaging / Q000453:epidemiology; D009436:Neural Tube Defects / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012189:Retrospective Studies; D012272:Ribs / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012600:Scoliosis / Q000151:congenital / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery; D013115:Spinal Canal / Q000002:abnormalities* / Q000000981:diagnostic imaging; D013131:Spine / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D013595:Syringomyelia / Q000151:congenital / Q000000981:diagnostic imaging / Q000453:epidemiology*; D044465:White People; D055815:Young Adult