Hidden neuroaxial pathology is common in idiopathic scoliosis: original research

Abstract

Abstract Purpose To study incidence of occult neuroaxial pathology (NAP) in patients with presumably idiophatic scoliosis in a largest spinal clinic in the Asian Part of Russia Methods We selected 401 patients who came to our clinic with presumably IS: we identified patterns of hidden neuraxial pathology (NAP) and its frequency. In addition to the main part of the study we assessed the reliability of MR-measuring of the pedicles to plan screw width and trajectory. Results Among 401 patients 53 (13%) found NAP: the proportion of males at this group was higher (42% vs 21%, p=0.004), the age of onset of the deformity was less (8.9±3.77 vs 9.9±3.93 years old, p=0.045), left-sided thoracic curve met more often (21% vs 8%, p=0.016), thoracic kyphosis was more pronounced (p=0.070) and the percentage of revision surgeries for deformity progression or non-fusion was higher (13% vs 5%, p=0.147). Conclusions MRI of the spine should be performed at the early stages of IS, since in some cases of NAP (Chiari, tethered spinal cord) there is the possibility of an early neurosurgical operation that will prevent the development of scoliosis. Main signs of hidden NAP in IS are: early onset IS, IS with left-sided thoracic curve, male gender and thoracic kyphosis > 40°Cobb.