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PURPOSE: 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). CONCLUSION: 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.

Original publication

DOI

10.1007/s00586-012-2538-y

Type

Journal article

Journal

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

Publication Date

02/2013

Volume

22

Pages

355 - 359

Addresses

Department of Orthopaedics, Alder Hey Children's Hospital, Liverpool L12 2AP, UK. singhal.rohit75@gmail.com

Keywords

Spine, Humans, Scoliosis, Syringomyelia, Arnold-Chiari Malformation, Magnetic Resonance Imaging, Neurologic Examination, Preoperative Care, Decompression, Surgical, Retrospective Studies, Child, Female, Male