An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: Proposal for a selective whole-spine MRI examination scheme

10.21203/rs.2.17338/v3 ◽

2020 ◽

Author(s):

Wei Xu ◽

Xiangyang Zhang ◽

Ying Zhu ◽

Xiaodong Zhu ◽

zhikun li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Abdominal Wall ◽

Incidence Rates ◽

Categorical Variables ◽

Continuous Variables ◽

Ankle Clonus ◽

Adolescent Patients ◽

Whole Spine ◽

Spine Mri

Abstract Objective This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities(IA). Method The clinical data of adolescent patients between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. 12 data were compared between the two groups. Student’s t test and the chi-square test were used to evaluate the differences in the continuous variables and categorical variables. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities. Result A total of 714 adolescent patients with scoliosis with a mean age of 13.5 (10-18 years) were included in the study, and IA were found in 68 (9.5%) patients. There were statistically significant differences in the incidence rates of intramedullary abnormalities between males and females, left and right thoracic curvatures, angular scoliosis and smooth scoliosis, and abnormal abdominal wall reflex and ankle clonus (P<0.01). Logistic regression showed that the ratios for sex, scoliosis direction, scoliosis type, abdominal wall reflex and ankle clonus were 2.987, 3.493, 4.823, 3.94 and 8.083, respectively. The ROC curve showed a sensitivity of 66.18% and a specificity of 89.01%(0.5519). Conclusion The incidence of scoliosis caused by IA was approximately 9.5%.The risk factors associated with AS caused by abnormal IA included the male sex, thoracic scoliosis on the left side, a sharp curvature of the spine, an abnormal abdominal wall reflex and ankle clonus.

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An analysis of clinical risk factors for adolescent scoliosis caused by spinal cord abnormalities in China: Proposal for a selective whole-spine MRI examination scheme

10.21203/rs.2.17338/v2 ◽

2020 ◽

Author(s):

Wei Xu ◽

Xiangyang Zhang ◽

Ying Zhu ◽

Xiaodong Zhu ◽

zhikun li ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Abdominal Wall ◽

Incidence Rates ◽

Categorical Variables ◽

Continuous Variables ◽

Ankle Clonus ◽

Adolescent Patients ◽

Whole Spine ◽

Spine Mri

Abstract Objective This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities(IA). Method The clinical data of adolescent patients between July 1, 2013, and December 31, 2018, were reviewed. According to the whole-spine MRI results, the patients were divided into either the idiopathic group or the intramedullary abnormality group. 12 data were compared between the two groups. Student’s t test and the chi-square test were used to evaluate the differences in the continuous variables and categorical variables. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities. Result A total of 714 adolescent patients with scoliosis with a mean age of 13.5 (10-18 years) were included in the study, and IA were found in 68 (9.5%) patients. There were statistically significant differences in the incidence rates of intramedullary abnormalities between males and females, left and right thoracic curvatures, angular scoliosis and smooth scoliosis, and abnormal abdominal wall reflex and ankle clonus (P<0.01). Logistic regression showed that the ratios for sex, scoliosis direction, scoliosis type, abdominal wall reflex and ankle clonus were 2.987, 3.493, 4.823, 3.94 and 8.083, respectively. The ROC curve showed a sensitivity of 66.18% and a specificity of 89.01%(0.5519). Conclusion The incidence of scoliosis caused by IA was approximately 9.5%.The risk factors associated with AS caused by abnormal IA included the male sex, thoracic scoliosis on the left side, a sharp curvature of the spine, an abnormal abdominal wall reflex and ankle clonus.

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Serologic and Histologic Predictors of Long-Term Renal Outcome in Biopsy-Confirmed IgA Nephropathy (Haas Classification): An Observational Study

Journal of Clinical Medicine ◽

10.3390/jcm8060848 ◽

2019 ◽

Vol 8 (6) ◽

pp. 848 ◽

Cited By ~ 5

Author(s):

Shang-Feng Tsai ◽

Ming-Ju Wu ◽

Mei-Chin Wen ◽

Cheng-Hsu Chen

Keyword(s):

Risk Factors ◽

Iga Nephropathy ◽

Neutrophil To Lymphocyte Ratio ◽

Renal Outcome ◽

Categorical Variables ◽

Youden Index ◽

Renal Survival ◽

Platelet To Lymphocyte Ratio ◽

Predictive Values ◽

Lymphocyte Ratio

Background and objective: The Haas classification of IgA nephropathy should be validated for Asian populations. More detailed and newer predictions regarding renal outcome of IgA nephropathy remains mandatory. Materials: We conducted a retrospective cohort study between January 2003 and December 2013. Clinical, Pathological, and laboratory data were all collected via available medical records. A Mann–Whitney U test was used for continuous variables and the Chi-square test was implemented for categorical variables. A Kaplan–Meier curve was put in place in order to determine patient survival and renal survival. The Youden index and Cox proportional hazard regression were used to investigate the possible factors for renal survival and predictive power. Results: All 272 renal biopsy-confirmed IgAN patients were enrolled for further studies. The univariate analysis showed that risk factors for poor renal outcome included stage 4–5 of Haas classification (HR = 3.67, p < 0.001), a poor baseline renal function (HR = 1.02 and p < 0.001 for higher BUN; HR = 1.14 and p < 0.001 for higher serum creatinine; HR = 0.95, p < 0.001 for higher eGFR), IgG ≤ 907 (HR = 2.29, p = 0.003), C3 ≤ 79.7 (HR = 2.76, p = 0.002), a higher C4 (HR = 1.02, p = 0.026), neutrophil-to-lymphocyte ratio > 2.75 (HR = 2.92, p < 0.001), and a platelet-to-lymphocyte ratio ≥ 16.06 (HR = 2.02, p = 0.012). A routine-checked markers, such as neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, in order to predict the renal outcome, is recommended. Conclusions: This is the first study to demonstrate that Haas classification is also useful for establishing predictive values in Asian groups. A lower serum IgG (≤907 mg/dL) and serum C3 (≤79.7 mg/dL) were both risk factors for poor renal outcome. Additionally, this is the first study to reveal that serum C4 levels, an NLR > 2.75 and a PLR > 16.06, S could suggest poor renal outcome.

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The association between homocysteine levels and cardiovascular disease risk among middle-aged and elderly adults in Taiwan

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-02000-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chin-Chuan Shih ◽

Yu-Lin Shih ◽

Jau-Yuan Chen

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Logistic Regression ◽

Homocysteine Level ◽

Disease Risk ◽

Pearson Correlation ◽

Youden Index ◽

Elderly Adults ◽

Middle Aged ◽

Cvd Risk

Abstract Background Our study aimed to determine the association between homocysteine levels and cardiovascular disease (CVD) risk in middle-aged and elderly adults in a community in northern Taiwan. Methods Participants in our study included adults aged 50 to 85 years old during community health examinations in 2019. A total of 396 people were enrolled, the ethnicity of all participants is Chinese. We divided participants according to tertiles of ln[homocysteine] level (low, middle and high groups). The CVD risk was calculated by the Framingham cardiovascular risk score (FRS). An FRS ≥ 20% indicated high CVD risk. Pearson correlation coefficients were calculated between homocysteine level and other cardio-metabolic risk factors while adjusting for age. Multivariate logistic regression analysis was used to determine the association of high and middle ln[homocysteine] groups with high CVD risk after adjusting age, sex, uric acid, creatinine, and body mass index (BMI). The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value. Results There were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 64.79 (± 8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, higher ln[homocysteine] levels was associated with higher CVD risk with a odds ratio (OR) of 2.499 and 95% confidence interval (CI) of 1.214 to 5.142 in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors. The area under the ROC curve was 0.667, and a ln[homocysteine] cut-off value of 2.495 µmol/L was determined. Conclusions Middle-aged and elderly people with increased homocysteine levels were associated with higher FRSs in this Taiwan community. Furthermore, homocysteine was an independent risk factor for high CVD risk in this study.

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The Association Between Homocysteine Levels and Cardiovascular Disease Risk Among Middle-Aged and Elderly Adults in Taiwan

10.21203/rs.3.rs-120665/v1 ◽

2020 ◽

Author(s):

Chin-Chuan Shih ◽

Yu-Lin Shih ◽

Jau-Yuan Chen

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Logistic Regression ◽

Homocysteine Level ◽

Disease Risk ◽

Pearson Correlation ◽

Youden Index ◽

Elderly Adults ◽

Middle Aged ◽

Cvd Risk

Abstract Background Our study aimed to determine the association between homocysteine levels and cardiovascular disease (CVD) risk in middle-aged and elderly adults in a community in northern Taiwan.MethodsParticipants in our study included adults aged 50 to 85 years old during community health examinations on 2019. A total of 396 people were enrolled. We divided participants according to tertiles of homocysteine level (low, middle and high groups). The CVD risk was calculated by the Framingham cardiovascular risk score (FRS). An FRS ≥ 20% indicated high CVD risk. Pearson correlation coefficients were calculated between homocysteine level and other cardio-metabolic risk factors while adjusting for age. High CVD risk in the middle and high homocysteine groups was compared with that in the low homocysteine group by multivariate logistic regression with adjustments for age, sex, smoking, hypertension (HTN), diabetes mellitus (DM), body mass index (BMI) and hyperlipidemia. The Youden index and receiver operating characteristic (ROC) curves were performed to determine the optimized cut-off value.ResultsThere were 396 people enrolled for analysis; 41.4% of participants were male, and the average age was 63.72 (±8.76). In our study, we showed a positive correlation of homocysteine with FRS. In the logistic regression models, the prevalence of high CVD risk was increased as homocysteine increased. The odds ratio (OR) and 95% confidence interval for high CVD risk was 2.851 (1.402 to 5.801) in the high homocysteine level group compared with the low homocysteine group after adjusting for traditional CVD risk factors (P=0.004). The area under the ROC curve was 0.67, and a homocysteine cut-off value of 12.15 µmol/L was determined.ConclusionsMiddle-aged and elderly people with increased homocysteine levels were associated with higher FRSs in this Taiwan community. Furthermore, homocysteine was an independent risk factor for high CVD risk in this study.

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Creatinine > 1.5 Mg/Dl and MDS Diagnosis Predicts Poor Outcome Following HSCT

Blood ◽

10.1182/blood.v126.23.3220.3220 ◽

2015 ◽

Vol 126 (23) ◽

pp. 3220-3220

Author(s):

Fern Martin ◽

Lekha Mikkilineni ◽

Kinjal Parikh ◽

Dolores Grosso ◽

Benjamin E Leiby ◽

...

Keyword(s):

Risk Factors ◽

Renal Failure ◽

Logistic Regression ◽

Renal Disease ◽

Prognostic Indicators ◽

Categorical Variables ◽

Hematopoietic Stem ◽

Allogeneic Hsct ◽

Specific Risk ◽

Increased Risk

Abstract Introduction Acute renal failure (ARF) after hematopoietic stem cell transplantation (HSCT) is an important complication associated with transplant-related mortality (TRM). In the first 100 days after HSCT, ARF can be secondary to other major complications, such as sepsis, sinusoidal obstruction syndrome, acute graft-versus-host disease (GVHD), and viral reactivation.ARF also occurs in the setting of nephrotoxic drugs, such as amphotericin B,and calcineurin inhibitors. We hypothesize that risk factors for ARF after HSCT include pre-transplant comorbidities, such as chronic kidney disease (CKD), acute kidney injury (AKI) prior to HSCT and hypertension. Mortality is greater in patients with ARF after HSCT than those without ARF. When ARF requires hemodialysis (HD), the mortality rate rises to greater than 80%. The aim of this study was to identify prognostic indicators for the development of ARF requiring HD or leading to death within 100 days after HSCT. Methods We performed a retrospective analysis of patients undergoing allogeneic HSCT at Thomas Jefferson University Hospital to identify prognostic indicators for poor outcomes after HSCT. We analyzed data for all patients who underwent allogeneic HSCT between the years of 2004-2014. After initial analysis, we excluded subjects who had diagnoses for which there were less than twenty patients. Univariate analysis was performed to identify risk factors for ARF requiring HD, 30-day mortality and 100-day mortality. Univariate association of categorical variables with outcomes and potential confounding variables was assessed using exact Chi-square tests. All variables associated with outcomes with p<0.2 were entered into a logistic regression model with the final model being selected using a backward elimination procedure until all variables had p<0.2. Results We analyzed 373 consecutive patients who underwent allogeneic HSCT at our institution between 2004 and 2014. After excluding diagnoses with less than twenty patients, we analyzed the remaining 332 patients. Median age was 54 years (range 19-78) and 42% of subjects were female. Diagnoses included acute myeloid leukemia (44.3 %), non-Hodgkin lymphoma (22.3%), acute lymphoid leukemia (14.8 %), myelodysplastic syndrome (MDS) (11.8%) and multiple myeloma (6.9%). Univariate associations between risk factors and three outcomes- renal failure requiring HD, 30-day mortality and 100-day mortality, were assessed. Within this set of 332 subjects, the incidence of renal failure requiring HD was 11.8%., 30-day mortality was 6.3%, and 100-day mortality was 16.6%. Creatinine >1.5 mg/dL at the time of HSCT was significantly associated with these outcomes. In addition, the diagnosis of MDS was associated with both 100-day mortality (p <0.001) and HD (p =0.0091). An increase in creatinine by 50% or greater between the time of admission and the day of HSCT was associated with need for HD (p =0.0026). Final logistic regression models show that candidate variables for predicting 30-day mortality were creatinine >1.5 mg/dL on the day of HSCT (p =0.045), use of amphotericin (p =0.052), and diagnosis of MDS (p =0.11). Candidate variables for predicting 100-day mortality were creatinine >1.5 mg/dL on the day of (p =0.023), diagnosis of MDS (p =0.035), and each one year increase in age (p =0.013). Candidate variables for renal failure requiring HD were creatinine >1.5 mg/dL on the day of HSCT (p <0.001) and a diagnosis of MDS (p =0.03). Creatinine at HSCT and diagnosis were included in all models. Discussion Although preexisting renal disease is incorporated into current models of risk at the time of transplant (e.g. HCT-CI), the specific risk for HD has not previously been quantified. Our analysis shows an 11.8% risk of ARF requiring HD following HSCT, with increased risk related to preexisting renal disease and underlying diagnosis of MDS. This suggests that patients should be counseled appropriately about this specific risk of renal failure requiring HD if the creatinine is >1.5 mg/dL. Similarly, patients with creatinine >1.5 mg/dL at time of HSCT are also at increased risk of 30-day and 100-day mortality compared to their counterparts with creatinine ≤1.5. Disclosures No relevant conflicts of interest to declare.

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Risk factors of mortality for intensive care COVID-19 patients: A retrospective cohort study.

10.21203/rs.3.rs-90168/v1 ◽

2020 ◽

Author(s):

Yanli Gu ◽

Donghui Wang ◽

Cen Chen ◽

Wanjun Lu ◽

Hongbing Liu ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Intensive Care ◽

Multivariate Logistic Regression Analysis ◽

Categorical Variables ◽

Continuous Variables ◽

Chi Square ◽

Laboratory Findings ◽

Chi Square Test ◽

Student’S T

Abstract Aims: To identify the risk factors of mortality for coronavirus disease 19 (COVID-19) patients admitted to intensive care units (ICU), we conducted a retrospective analysis.Methods: The demographic characteristics, laboratory findings and chest X-ray data of COVID-19 patients admitted to ICU of Huoshenshan Hospital from February 10 to April 10, 2020 were retrospectively analyzed. Student's t test and chi-square test were used to compare continuous variables, categorical variables respectively. Logistic regression model was used to seek risk factors of mortality.Results: A total of 57 patients (38 males and 19 females) were included in this retrospective study, including 20 patients in deceased group and 37 patients in surviving group. Leukocyte count, neutrophil count, lymphocyte count, eosinophil count, neutrophil-to-lymphocyte ratio (NLR), urea nitrogen, lactate dehydrogenase (LDH), interleukin-6 (IL-6), C-reactive protein (CRP), arterial partial pressure of oxygen/oxygen concentration (PaO2/FiO2) and imaging findings were statistically different between the two groups. The multivariate logistic regression analysis identified IL-6 and PaO2/FiO2 as independent risk factors of mortality. The area of under curves (AUC) of IL-6 and PaO2/FiO2 were 0.9 (95%CI:0.823-0.977, p<0.0001) and 0.865 (95%CI:0.774-0.956, p<0.0001) respectively. The cut-off value of IL-6 was 25.69 pg/mL, the sensitivity was 95% and the specificity was 75.7%, while the cut-off value of PaO2/FiO2 was 167.79 mmHg, the sensitivity was 75.7% and the specificity was 85%.Conclusion: Clinicians should pay enough attention to IL-6 and PaO2/FiO2, especially when IL-6>25.69 pg/ml and PaO2/FiO2<167.79 mmHg, and take active intervention measures as early as possible.

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Abstract WP220: The Effect of Self-Reported Optimism on the Incidence of Stroke

Stroke ◽

10.1161/str.48.suppl_1.wp220 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Ahmed Malik ◽

Haseeb Rahman ◽

Adnan Qureshi ◽

Martha A Wojtowycz

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Regression Analysis ◽

Standard Deviation ◽

Confidence Interval ◽

Stroke Prevention ◽

Odds Ratio ◽

Categorical Variables ◽

The Mean ◽

Baseline Characteristics

Purpose: The purpose of this study is to determine whether having an optimistic outlook on life decreases the risk of developing incident stroke. Methods: Participants who developed incident stroke in Americans’ Changing Lives study, and participants who did not develop incident stroke (dependent variable) in were compared for demographics, baseline characteristics, comorbidities, and optimistic outlook on life. Numbers and proportions of respondents in both groups were reported for all categorical variables, while mean and standard deviation were reported for age. All statistically significant variables from the above analyses were entered into a logistic regression analysis to ascertain the association between optimistic outlook on life and stroke. Results: Of the 98,577,928 participants, 73,040,055 did not have stroke at baseline. There were 599,190 who developed incident stroke and 1,104,751 who did not develop incident stroke. The mean age (standard deviation) was lower in those who developed incident stroke compared to those who did not [45.9 (13.8) vs. 46.4 (9.9) p<.0001], and participants with an optimistic outlook on life, were 0.20 times less likely to develop stroke as those who did not have an optimistic outlook on life [OR (Odds ratio) 0.20 95% CI (95% confidence interval) 0.20,0.21], after adjusting for confounders. Conclusions: People who have an optimistic outlook on life are less likely to develop incident stroke. The protective value of optimism lends credence to the value of targeting unconventional risk factors in stroke prevention.

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MO824PREDICTORS OF MORTALITY OF COVID-19 IN CHRONIC HEMODIALYSIS PATIENTS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab098.0016 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Catarina Almeida ◽

Marina Sofia Rodrigues Reis ◽

Daniela Alferes ◽

Catarina Isabel Ribeiro ◽

Sara Daniela Rodrigues ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Logistic Regression ◽

Hemodialysis Patients ◽

Chronic Hemodialysis ◽

Categorical Variables ◽

Continuous Variables ◽

Dialysis Patients ◽

Hospitalization Time ◽

Bacterial Superinfection

Abstract Background and Aims Coronavirus disease 2019 (COVID-19) has affected the care of patients on chronic hemodialysis (HD). It has been reported that older adults and those with comorbidities, such as diabetes mellitus, hypertension, cardiovascular disease and chronic kidney disease are prone to develop severe disease and poorer outcomes. By virtue of their average old age, multiple comorbidities, immunosuppression and frequent contact with other patients in dialysis facilities, chronic HD patients are at particular risk for severe COVID-19 infection. The aim of this study was to compare clinical presentation, laboratory and radiologic data and outcomes between HD and non-HD COVID-19 patients and find possible risk factors for mortality on HD patients. Method A single center retrospective cohort study including patients on HD hospitalized with a laboratory confirmed COVID-19 infection, from March 1st to December 31st of 2020 and matched them to non-dialysis patients (non-HD) (1:1). Data regarding patient baseline characteristics, symptoms, laboratory and radiologic results at presentation were collected, as well as their outcomes. Categorical variables are presented as frequencies and percentages, and continuous variables as means or medians for variables with skewed distributions. A paired Student’s t-test was performed on parametric continuous values or Mann-Whitney for non-parametric continuous variables. Chi-squared test was performed for comparing categorical variables. Logistic regression was used to identify risk factors for mortality on HD patients. A p-value of less than 0,05 indicated statistical significance. Results A total of 34 patients HD patients were included, 70,6% male, mean age of 76,5 years, median time of dialysis of 3,0 years. Among them 85,3% were hypertensive, 47,1% diabetic, 47,1% had cardiovascular disease, 30,6% pulmonary chronic disease and 23,5% cancer. The most frequent symptoms were fever (67,6%), shortness of breath (61,8%) and cough (52,9%). At admission, 55,9% of patients needed oxygen supply, one required mechanic ventilation and was admitted to intensive care unit. Regarding laboratory data, the most common features were lymphopenia in 58,9% (median- 795/uL), elevated LDH in 64,7% (median- 255 U/L), raised C-reactive protein in 97,1% (median-6,3 mg/dlL, raised D-dimer in 95,8% (median 1,7 ng/mL), and all patients presented high ferritin (median 1658 ng/mL) and elevated Troponin T (median 130ng/mL). The majority presented with radiologic changes, particularly bilateral infiltrates in 29,4%. Concerning clinical outcomes, the median hospitalization time was 11 days and 13 patients (38,2%) developed bacterial superinfection. Mortality rate was 32,4%. When matched to 34 non-HD patients there was no statistical significant differences in sex, age and comorbidities. The HD group had a tendency to more ventilator support need (p=0,051), higher ferritin and troponin levels (p=<0,001 for both), whereas the non-HD group presented with greater levels of transaminases (p= 0,017). There was o significant difference in hospitalization time (median of 11 vs 7 days, p=0,222) neither in mortality (median of 32,4 vs 35,3%, p=0,798). When the logistic regression was performed, only bacterial superinfection was a predictor for mortality on hemodialysis patients (p=0,004). Conclusion Our study compared outcomes for COVID-19 patients on chronic HD to non-dialysis patients and showed no difference in hospitalization time nor in death rate. In spite of these results, the mortality in patients on chronic HD is still not negligible, with up to 32% of in-hospital mortality. Bacterial superinfection is a predictive risk factor for mortality. Hence the importance of interventions to mitigate the burden of COVID-19 in these patients, by preventing its spread, particularly in hemodialysis centers.

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Preoperative Magnetic Resonance Imaging Evaluation in Patients with Adolescent Idiopathic Scoliosis

Asian Spine Journal ◽

10.4184/asj.2017.11.1.37 ◽

2017 ◽

Vol 11 (1) ◽

pp. 37-43 ◽

Cited By ~ 6

Author(s):

Choon Sung Lee ◽

Chang Ju Hwang ◽

Nam Heun Kim ◽

Hyun Min Noh ◽

Mi Young Lee ◽

...

Keyword(s):

Idiopathic Scoliosis ◽

Thoracic Kyphosis ◽

Resonance Imaging ◽

Mri Findings ◽

Height Difference ◽

Coronal Balance ◽

Neural Axis ◽

Preoperative Magnetic Resonance ◽

Whole Spine ◽

Spine Mri

<sec><title>Study Design</title>Retrospective case series.</sec><sec><title>Purpose</title>The purpose of this study was to examine the incidence of neural axis abnormalities and the relevant risk factors in patients with adolescent idiopathic scoliosis (AIS).</sec><sec><title>Overview of Literature</title>The use of preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with idiopathic scoliosis is controversial, and indications for such MRI evaluations have not been definitively established. However, we routinely use whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction.</sec><sec><title>Methods</title>A total of 378 consecutive patients with presumed AIS who were admitted for spinal surgery were examined for neural axis abnormalities using MRI. To differentiate patients with normal and abnormal MRI findings, the following clinical parameters were evaluated: age, sex, menarcheal status, rotation angle (using a scoliometer), coronal balance, shoulder height difference, and low back pain. We radiographically evaluated curve type, thoracic or thoracolumbar curve direction, curve magnitude and flexibility, apical vertebral rotation, curve length, coronal balance, sagittal balance, shoulder height difference, thoracic kyphosis, and the Risser sign.</sec><sec><title>Results</title>Neural axis abnormalities were detected in 24 patients (6.3%). Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in terms of the other measured parameters.</sec><sec><title>Conclusions</title>Among the patients with presumed AIS who received preoperative whole-spine MRI, 6.3% had neural axis abnormalities. Males and patients with increased thoracic kyphosis were at a higher risk.</sec>

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