Preoperative MRI Doesn't Affect Scoliosis Surgery Outcomes

MRI for scoliosis in adolescents may not impact outcomes even if abnormality detected

WEDNESDAY, April 27 (HealthDay News) -- Preoperative magnetic resonance imaging (MRI) for adolescent idiopathic scoliosis may not affect the surgical outcome even if a neural abnormality is detected, according to a study published in the April 15 issue of Spine.

Mohammad Diab, M.D., from the University of California in San Francisco, and colleagues reported the use and outcomes of preoperative MRI in adolescents undergoing surgery for scoliosis. A total of 2,203 patients with scoliosis, aged 8 to 18 years, from the Spinal Deformity Study Group underwent posterior spinal fusion and instrumentation. Of these, 923 (41.8 percent) had a spine MRI before undergoing surgery.

The investigators identified 91 abnormalities of the spine, of which 4.2 percent were neural. Neural abnormalities included syringes (66.7 percent), Chiari malformations (30.7 percent), and tethered cord (2.6 percent). Abnormalities affecting parts of the spine other than neural elements were evident in 5.7 percent of patients. Patients undergoing MRI were significantly more likely to be male, have a diagnosis of juvenile idiopathic scoliosis, have thoracic hyperkyphosis, have a Risser grade between 0 and 2, have a greater curve magnitude, have three major curves, and undergo a combined anterior-posterior surgical approach. Juvenile-onset patients and those with thoracic hyperkyphosis were more likely to have a neural lesion on their spine MRI. No significant difference was observed in incidence of abnormal MRI based on male gender, body mass index, direction of apex, Risser grade, or curve magnitude or type.

"There were no neural or other complications to surgical treatment of adolescent idiopathic scoliosis in the setting of an MRI neural abnormality and normal neural examination," the authors write.

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