scholarly journals Preoperative Magnetic Resonance Imaging Evaluation in Patients with Adolescent Idiopathic Scoliosis

2017 ◽  
Vol 11 (1) ◽  
pp. 37-43 ◽  
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><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>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).</p></sec><sec><title>Overview of Literature</title><p>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.</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec>

Magnetic Resonance Imaging Abnormalities of Neural Axis in Lenke Type 1 Idiopathic Scoliosis

Spine ◽  
2006 ◽  
Vol 31 (16) ◽  
pp. 1828-1833 ◽  
Author(s):  
Í Teoman Benli ◽  
Onat Üzümcügil ◽  
Erbil Aydin ◽  
Bülent Ateş ◽  
Levent Gürses ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Idiopathic Scoliosis ◽  
Resonance Imaging ◽  
Neural Axis

Predictive Value of Preoperative Magnetic Resonance Imaging Findings for Survival and Local Recurrence in Patients Undergoing En Bloc Resection of Sacral Chordomas

Neurosurgery ◽  
2018 ◽  
Vol 85 (6) ◽  
pp. 834-842 ◽  
Author(s):  
Scott L Zuckerman ◽  
Behrang Amini ◽  
Sun-Ho Lee ◽  
Ganesh Rao ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Independent Predictor ◽  
Multivariable Analysis ◽  
Subcutaneous Fat ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Resonance Imaging ◽  
Mri Findings ◽  
En Bloc ◽  
Preoperative Magnetic Resonance ◽  
Si Joint

Abstract BACKGROUND Few studies have assessed the prognostic importance of preoperative magnetic resonance imaging (MRI) scan findings in patients undergoing en bloc resection of sacral chordomas. OBJECTIVE To (1) report in-depth imaging characteristics of sacral chordomas, (2) describe the patterns of local and distant recurrence, and (3) determine imaging predictors of overall survival (OS) and local recurrence (LR). METHODS This retrospective case series was obtained from a prospectively maintained spine database from 1995 to 2016. All patients underwent en bloc resection of sacral chordomas. Detailed demographic, outcome, and MRI data were collected. A survival analysis was completed with multivariable cox regression to assess the impact of MRI findings on OS and LR. RESULTS A total of 41 patients underwent en bloc resection of sacral chordoma with preoperative MRI scans. Tumor characteristics included lobulated: (93%) and soft tissue tail (54%). The following areas had tumor invasion lobulated: sacroiliac (SI) joint (15%), ilium (5%), piriformis (61%), gluteus (46%), subcutaneous fat (32%), and lumbosacral venous plexus (22%). After multivariable analysis, only subcutaneous fat extension was an independent predictor of decreased OS (hazard ratio 5.30, 95% confidence interval 1.47-19.19, P = .011). Though not significant after multivariable analysis, the following factors were significant predictors of LR after univariate logrank testing: above the L5/S1 disc space (P = .004), SI joint invasion (P = .036), and piriformis extension (P = .022). CONCLUSION The presence of subcutaneous fat extension was an independent predictor of decreased OS. Other MRI findings with potential for future evaluation include size, presence of soft tissue tail, extension above L5/S1, and SI joint and piriformis invasion.

scholarly journals 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

2019 ◽  
Author(s):  
Wei Xu ◽  
Xiangyang Zhang ◽  
Ying Zhu ◽  
zhikun li ◽  
Xiaodong Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Idiopathic Scoliosis ◽  
Abdominal Wall ◽  
Categorical Variables ◽  
Youden Index ◽  
Ankle Clonus ◽  
Intraspinal Anomalies ◽  
Whole Spine ◽  
Spine Mri

Abstract Background This study examined the risk factors for non-idiopathic scoliosis with intramedullary abnormalities, explored the feasibility of whole-spine MRI, and provided a theoretical basis for the routine diagnosis and treatment of adolescent idiopathic scoliosis. Method The clinical data of adolescent scoliosis patients who were admitted to Shanghai Tongren Hospital and Shanghai Changhai Hospital 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. Sex, age, main curvature angle, main curvature direction, kyphosis angle, scoliosis type, coronal plane balance, sagittal plane balance, abdominal wall reflex, sensory abnormality, ankle clonus and tendon reflexes were compared between the two groups. Student’s t test was used to evaluate the differences in the continuous variables, and the chi-square test was used to evaluate the differences in the categorical variables. Fisher’s exact test was applied to detect the difference in the rate of intraspinal anomalies between the groups. Logistic regression was used to evaluate the correlation between the multivariate risk factors and intramedullary abnormalities. Result A total of 714 adolescent scoliosis patients with a mean age of 13.5 (10-18 years) were included in the study, and intramedullary abnormalities 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%, and the Youden index corresponding to the optimal critical point was 0.5519. Conclusion Risk factors associated with adolescent scoliosis caused by abnormal intramedullary abnormalities included male sex, thoracic scoliosis on the left side, sharp curvature of the spine, abnormal abdominal wall reflex and ankle clonus. These clinical indicators suggest that there is a high-risk adolescent scoliosis population who should undergo whole-spinal MRI preoperatively to rule out intramedullary abnormalities.

scholarly journals Relationship between thoracic kyphosis and neural axis abnormalities in patients with adolescent idiopathic scoliosis

2018 ◽  
Vol 12 (1) ◽  
pp. 63-69 ◽  
Author(s):  
I. Swarup ◽  
P. Derman ◽  
E. Sheha ◽  
J. Nguyen ◽  
J. Blanco ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Thoracic Kyphosis ◽  
Consecutive Series ◽  
Level Of Evidence ◽  
Neural Axis ◽  
Chi Squared ◽  
Thoracic Hyperkyphosis ◽  
Magnetic Resonance Imaging Mri ◽  
The Relationship

Purpose Previous studies have suggested an association between increased thoracic kyphosis and neural axis abnormalities in patients with adolescent idiopathic scoliosis (AIS). However, the basis for this finding is unclear, and this association has been mainly noted in retrospective studies on a non-consecutive series of patients. The purpose of this study was to assess the relationship between thoracic kyphosis and neural axis abnormalities in patients with AIS. Methods We studied a consecutive series of AIS patients treated with spinal fusion. Thoracic kyphosis (T2 to T12) was measured from preoperative lateral radiographs. All patients underwent a spine magnetic resonance imaging (MRI) prior to surgery, and MRI reports were reviewed to determine the presence of neural axis abnormalities. Statistical analyses included descriptive statistics and chi-squared analysis. Results This study included 210 patients with AIS. There were no significant differences in age or gender between patients with thoracic hypokyphosis (kyphosis < 20°), normal thoracic kyphosis (kyphosis 20° to 40°) and thoracic hyperkyphosis (kyphosis > 40°) (p > 0.05). Neural axis abnormalities were present in 17.9% of patients with thoracic hypokyphosis, 9.8% of patients with normal thoracic kyphosis and 13.6% of patients with thoracic hyperkyphosis (p = 0.60). There were no significant differences in rates of Chiari malformation, syrinx, intra-spinal masses and other central nervous system abnormalities between groups (p > 0.05). Conclusions Thoracic kyphosis was not associated with neural axis abnormalities in our consecutive series of patients with AIS. Increased thoracic kyphosis may not be a reliable indicator for the presence of neural axis abnormalities in patients with AIS. Level of Evidence IV

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