Radiologic Presentations in Relation to Curve Severity in Scoliosis Associated with Syringomyelia

Study Design/ Setting: The patients were divided into three groups and the radiologic characteristics were explored.

Patient Sample: 87 patients with scoliosis associated with Chiari malformation and syringomyelia were enrolled.

Outcome Measures: Curves were classified into typical and atypical patterns in coronal plane, and the sagittal profile was evaluated. Cerebellar tonsillar descent or syrinx patterns in relation to curve severity and the frequency of atypical curves were also investigated. Methods: 87 patients were divided into three groups according to Cobb angle: Group I (10-30 degrees), Group II (30-60 degrees), and Group III (Cobb angle>60 degrees). Curves were classified into typical and atypical patterns in coronal plane, and the sagittal profile was measured. Cerebellar tonsillar descent or syrinx patterns in relation to curve severity and the frequency of atypical curves were also investigated.

Results: The frequency of atypical curve patterns from Group I to III was 46.2%, 45.2%, and 40.7% respectively. 65.3% patients with typical curve patterns had atypical features in all of the three groups. There was a significant difference of kyphotic angle among the three groups. Both the degree of cerebellar tonsillar descent and syrinx patterns had no correlation with the curve severity or the frequency of atypical curves.

Conclusions: These results show that radiographic presentations including typical curve patterns, atypical features in typical curve patterns, and a normal to hyperkyphotic thoracic spinemay suggest the need for preoperative MRI. Kyphosis may be indicative of progressive scoliosis. There is no evidence to suggest that the degree of cerebellar tonsillar descent and syrinx patterns have an effect on the progress of scoliosis and the frequency of atypical curves.