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Magnetic resonance imaging effectiveness in adolescent idiopathic scoliosis

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Abstract

Objective

To assess the effectiveness of preoperative magnetic resonance imaging (MRI) in adolescent idiopathic scoliosis (AIS) patients with unremarkable history and physical examination.

Methods

The imaging data of consecutive patients with presumed AIS treated with a posterior spinal fusion between 2010 and 2016 were reviewed. The presence of traditional risk factors, atypical curve patterns, and its association with relevant abnormalities on MRI were investigated. The number needed to diagnose (NND) and the number needed to misdiagnose (NNM) were calculated to measure MRI effectiveness.

Results

A total of 198 consecutive patients were identified and divided according to the presence of MRI findings. Both groups predominantly consisted of females, with a mean age of 15 years and right thoracic curvature. Neural axis abnormalities were detected in 25 patients, and the groups had a similar proportion of atypical findings, as curve magnitude, thoracic kyphosis, curve direction, and sex. The NND was 7.9 patients and NNM was 66 patients, meaning that the management was changed before the spine fusion in 12% of patients with neural axis abnormalities. None of the traditional risk factors could predict a higher incidence of neural axis abnormalities in asymptomatic AIS patients.

Conclusion

Traditional risk factors may not be predictive of patients with a higher risk of changes in MRI. Both NND and NNM are representations easily understood by clinicians. Using these indexes to define if a patient should be submitted for additional imaging tests may facilitate the decision of using MRI as a preoperative screening tool in AIS patients.

Level of evidence

Level II

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Authors and Affiliations

  1. Department of Orthopedics, SARAH Network of Rehabilitation Hospitals, SMHS Qd 301 Bloco A, Brasília, DF, 70335-901, Brazil

    Rafael Garcia de Oliveira, Alex Oliveira de Araújo & Cícero Ricardo Gomes

Authors
  1. Rafael Garcia de Oliveira
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  2. Alex Oliveira de Araújo
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  3. Cícero Ricardo Gomes
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Contributions

RGO, AOA and CRG made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; drafted the work or revised it critically for important intellectual content; approved the version to be published; agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Rafael Garcia de Oliveira.

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Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

Research Ethics Committee approval: 2.751.862; 07/03/2018.

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de Oliveira, R.G., de Araújo, A.O. & Gomes, C.R. Magnetic resonance imaging effectiveness in adolescent idiopathic scoliosis. Spine Deform 9, 67–73 (2021). https://doi.org/10.1007/s43390-020-00205-2

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  • DOI: https://doi.org/10.1007/s43390-020-00205-2

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