Adolescent idiopathic scoliosis and the presence of spinal cord abnormalities. Preoperative magnetic resonance imaging analysis.

Abstract

Preoperative magnetic resonance imaging was performed on 45 consecutive patients diagnosed with adolescent idiopathic scoliosis to evaluate the brain and spinal cord. To investigate the prevalence of spinal cord abnormalities in patients undergoing surgery for adolescent scoliosis. A review of the literature indicates that the number of abnormalities of the brain stem and spinal cord reported with magnetic resonance imaging in patients with idiopathic scoliosis is increasing. Forty-five consecutive patients with idiopathic adolescent scoliosis were examined with magnetic resonance imaging to rule out underlying pathologic abnormalities of the brain stem or spinal cord. Two of 45 patients had abnormal findings on magnetic resonance imaging. One patient had a cervical cord syrinx from C4-T2 with an Arnold-Chiari malformation; the other patient had a syrinx from C6-C7. This study reports a higher than expected frequency of spinal cord abnormalities in patients with the preoperative diagnosis of adolescent idiopathic scoliosis. The indications for preoperative magnetic resonance imaging before spinal fusion vary among physicians; however, strict adherence to previously published recommendations as listed in this report is advisable. It appears from the results of this study that by following these guidelines, small syrinxes may remain undetected, but the clinical significance of this is unknown.