Should all paediatric patients with presumed idiopathic scoliosis undergo MRI screening for neuro-axial disease? View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-11

AUTHORS

Patrick A. Tully, Ben A. Edwards, Omar Mograby, Harriet S. M. Davis, Oluwole Arieskola, Shailendra Magdum, Prashanth Rao, Jayaratnam Jayamohan

ABSTRACT

BACKGROUND: Idiopathic scoliosis is a relatively common childhood condition affecting 0.47-5.2% of the population. Traditional interventions focus on orthopaedic correction of the curve angle. There is a spectrum of patients with scoliosis who are found to have neuro-axial abnormality on full MRI of the spine, but not all surgeons request imaging in the absence of neurological symptoms. There is evidence to suggest that treatment of neuro-axial disease may improve scoliosis curve outcome. We therefore sought to estimate what proportion of patients with normal neurology and scoliosis are found to have neuro-axial abnormality on full MRI imaging of the spine, in particular Chiari malformation and syringomyelia. RESULTS: Out of 11 identified studies consisting of 3372 paediatric patients (age < 18 years), mean weighted proportion demonstrates that 14.7% of patients with scoliosis (Cobb angle > 20°) and normal neurological examination will demonstrate a neuro-axial abnormality on full MRI imaging of the spine. Of patients, 8.3 and 8.4% were found to have Chiari malformation and syringomyelia, respectively. CONCLUSIONS: Up to one in seven paediatric patients with scoliosis and normal neurological examination will demonstrate neuro-axial disease on MRI imaging of the spine. Given that younger age and earlier age of decompression is associated with improvement in curve angle, it seems important that MRI screening be considered in all patients regardless of neurological examination findings. There is a potentially long-term benefit in these patients. Multi-cross institutional prospective studies are encouraged to further investigate effect on curve angle. More... »

PAGES

2173-2178

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00381-018-3878-7

DOI

http://dx.doi.org/10.1007/s00381-018-3878-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1105856271

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30051233


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