title: Patterns of congenital bony spinal deformity and associated neural anomalies on X-ray and magnetic resonance imaging.
abstract: OBJECTIVE
  Congenital malformations of the bony vertebral column are often accompanied by spinal cord anomalies; these observations have been reinforced with the use of magnetic resonance imaging (MRI). We hypothesized that the incidence of cord anomalies will increase as the number and complexity of bony vertebral abnormalities increases.
  
  
  METHODS
  All patients aged ≤13 years (n = 75) presenting to the pediatric spine clinic from 2003-2013 with congenital bony spinal deformity and both radiographs and MRI were analyzed retrospectively for bone and neural pathology. Chi-squared analysis was used to compare groups for categorical dependent variables. Independent t tests were used for continuous dependent variables. Significance was set at p < 0.05.
  
  
  RESULTS
  Fifty-five percent of congenital spine deformity patients (n = 41) had associated spinal cord anomalies on MRI. Complex bony abnormalities had a higher incidence of cord anomalies than simple abnormalities (67, 37 %; p = 0.011). Mixed deformities of segmentation and formation had a higher incidence of cord anomalies (73 %) than failures of formation (50 %) or segmentation (45 %) alone (p = 0.065). Deformities in the sacrococcygeal area had the highest rate of spinal cord anomalies (13 of 15 patients, 87 %). In 35 cases (47 %), MRI revealed additional bony anomalies that were not seen on the radiographs.
  
  
  CONCLUSIONS
  As the number of bony malformations increased, we found a higher incidence of cord anomalies. Clinicians should have increased suspicion of spinal cord pathology in the presence of mixed failures of segmentation and formation.
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 330, P.O. Box 800232, Charlottesville, 22908, VA, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Trenga
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 330, P.O. Box 800232, Charlottesville, 22908, VA, USA. AS7BV@hscmail.mcc.virginia.edu.
authors.forename: Anuj
authors.initials: A
authors.lastname: Singla
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 330, P.O. Box 800232, Charlottesville, 22908, VA, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Feger
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia, 400 Ray C. Hunt Drive, Suite 330, P.O. Box 800232, Charlottesville, 22908, VA, USA.
authors.forename: Mark F
authors.initials: MF
authors.lastname: Abel
keywords: Congenital spinal deformity; MRI; Scoliosis; Spinal cord; X-ray