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Total Spine MRI Screening in Idiopathic Scoliosis

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Written by M.S. Ganjavian, M.D., M.R. Etemadifar, M.D. and B. Mobini, M.D.

Abstract from the SRS 2004 Annual Meeting

Summary of Background Data: Performing routine MRI screening of the patients presenting as idiopathic scoliosis is a controversial issue. Considering our clinical experiences, we decided to perform routine MRI of posterior fossa and spine in all patients with idiopathic scoliosis and evaluate the results.

Patients and Methods: A prospective clinical study was performed. In all of the patients with clinical and radiological diagnosis of idiopathic scoliosis routine posterior fossa and total spine MRI was performed.

Results: Total number of the patients was 177 (132 females and 45 males).Average age of the patients was 15years (11to22). Average curve angle was 59 degrees (30 to 135). Convexity was to the right side in 146 and to the left in 31 cases. In 12 cases (6.8%) there were positive MRI findings (table). In 5 cases (2.8%) neurosurgical intervention was necessary prior to scoliosis surgery. There were no relation between age, sex, presence of pain or curve angle and positive MRI findings. (P>0.05) Left convexity had statistically significant relation with positive MRI findings (x2 test,P=0.02) and in male patients this relation was even more(p=0.01)

Conclusion: Considering our research results and other reported articles, it seems that performing routine total spine MRI in all of the patients presenting as idiopathic scoliosis is necessary for detection of any underlying abnormalities.

Key words: Idiopathic scoliosis, MRI, spine.

Demographic characteristics of patients with positive MRI findings
No	Age (years)	Sex	Location	Side	Degree	MRI findings	Neurosurgical intervention*
1	16	Female	T4-T11	Right	45°	Lowlying cord	+
2	14	Male	T7-L1	Left	97°	Syrinx C4-C7 +Chiari type 1	+
3	15	Female	T2-T7	Left	55°	Syrinx C5-C6	-
4	13	Female	T7-L1	Right	54°	Small syrinx	-
5	13	Female	T10-L1	Right	60°	Intramedullary lower thoracic tumur	+
6	18	Male	T4-T11	Right	42°	Syrinx (lower cervical & upper thoracic)	-
7	16	Male	T7-T12	Left	40°	Tethered cord	+
8	13	Female	T5-T11 T12-L1	Right Left	54° 30°	Syrinx (C6-T1)	-
9	18	Female	T1-T7 T8-L2	Right Left	90° 93°	Syrinx (Mid thoracic)	-
10	16	Male	T6-T12	Right	50°	Syrinx (thoracic)	-
11	14	Female	T5-T11	Left	60°	Syrinx (total cord)	+
12	13	Female	T7-L2	Left	78°	Platybasia	-
* required (+), not required (-)