Incidence of Intraspinal and Extraspinal MRI Abnormalities in Patients With Adolescent Idiopathic Scoliosis.
Adolescent idiopathic scoliosis
Extraspinal abnormalities
Intraspinal abnormalities
Magnetic resonance imaging
Journal
Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
02
12
2017
revised:
04
05
2018
accepted:
07
06
2018
entrez:
28
12
2018
pubmed:
28
12
2018
medline:
19
4
2019
Statut:
ppublish
Résumé
Retrospective study with follow-up. The purpose of this study was to determine the incidence of intraspinal and extraspinal MRI abnormalities in a consecutive series of patients with adolescent idiopathic scoliosis (AIS) and to describe the evaluation and management of these abnormalities. Indications for preoperative magnetic resonance imaging (MRI) in patients with AIS remain controversial. Previous studies have reported a wide range of abnormality rates; however, the majority of these studies focus on a nonconsecutive series of patients, and none of these studies report the incidence of extraspinal abnormalities. We studied a consecutive series of patients with AIS managed with spinal deformity surgery. All patients underwent a routine neural axis MRI prior to surgery. MRI reports were reviewed, and intraspinal and extraspinal abnormalities were recorded. Additional chart review and follow-up was performed to determine the rates of evaluation and management for these abnormalities. Descriptive statistics were used to describe the incidence and types of abnormalities, as well as the rates of evaluation and management. This study included a consecutive series of 259 patients with AIS. MRI abnormalities were noted in 115 patients (44%). After excluding patients with degenerative changes, MRI abnormalities were noted in 64 patients (25%). The incidence of Chiari malformation was 4.2% and syringomyelia was 5%. Extraspinal abnormalities were noted in 10% of patients, and these findings ranged from benign cysts to malignant soft tissue tumor. Approximately 10% of patients needed additional evaluation because of their preoperative MRI findings, and 0.7% of patients required surgical management prior to spinal deformity surgery. Significant MRI abnormalities were noted in patients with AIS, and some patients required further evaluation prior to surgery. Additional study including cost-effectiveness analysis is needed to better define the role of preoperative MRI in patients with AIS. Level II.
Sections du résumé
STUDY DESIGN
Retrospective study with follow-up.
OBJECTIVES
The purpose of this study was to determine the incidence of intraspinal and extraspinal MRI abnormalities in a consecutive series of patients with adolescent idiopathic scoliosis (AIS) and to describe the evaluation and management of these abnormalities.
SUMMARY OF BACKGROUND DATA
Indications for preoperative magnetic resonance imaging (MRI) in patients with AIS remain controversial. Previous studies have reported a wide range of abnormality rates; however, the majority of these studies focus on a nonconsecutive series of patients, and none of these studies report the incidence of extraspinal abnormalities.
METHODS
We studied a consecutive series of patients with AIS managed with spinal deformity surgery. All patients underwent a routine neural axis MRI prior to surgery. MRI reports were reviewed, and intraspinal and extraspinal abnormalities were recorded. Additional chart review and follow-up was performed to determine the rates of evaluation and management for these abnormalities. Descriptive statistics were used to describe the incidence and types of abnormalities, as well as the rates of evaluation and management.
RESULTS
This study included a consecutive series of 259 patients with AIS. MRI abnormalities were noted in 115 patients (44%). After excluding patients with degenerative changes, MRI abnormalities were noted in 64 patients (25%). The incidence of Chiari malformation was 4.2% and syringomyelia was 5%. Extraspinal abnormalities were noted in 10% of patients, and these findings ranged from benign cysts to malignant soft tissue tumor. Approximately 10% of patients needed additional evaluation because of their preoperative MRI findings, and 0.7% of patients required surgical management prior to spinal deformity surgery.
CONCLUSIONS
Significant MRI abnormalities were noted in patients with AIS, and some patients required further evaluation prior to surgery. Additional study including cost-effectiveness analysis is needed to better define the role of preoperative MRI in patients with AIS.
LEVEL OF EVIDENCE
Level II.
Identifiants
pubmed: 30587320
pii: S2212-134X(18)30125-4
doi: 10.1016/j.jspd.2018.06.006
pii:
doi:
Types de publication
Evaluation Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
47-52Informations de copyright
Copyright © 2018 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.