International Orthopaedics

, Volume 34, Issue 4, pp 543–546 | Cite as

The role of routine magnetic resonance imaging in the preoperative evaluation of adolescent idiopathic scoliosis

  • Cagatay Ozturk
  • Selhan Karadereler
  • Ibrahim Ornek
  • Meric Enercan
  • Kursat Ganiyusufoglu
  • Azmi Hamzaoglu
Original Paper


The routine use of magnetic resonance imaging (MRI) in adolescent idiopathic scoliosis remains controversial, and current indications for MRI in idiopathic scoliosis vary from study to study. The purpose of this study was to demonstrate the prevalence of neural axis malformations and the clinical relevance of routine MRI studies in the evaluation of patients with adolescent idiopathic scoliosis undergoing surgical intervention without any neurological findings. A total of 249 patients with a diagnosis of idiopathic scoliosis were treated surgically between the years 2002 and 2007. A routine whole spine MRI analysis was performed in all patients. On the preoperative clinical examination, all patients were neurologically intact. There were 20 (8%) patients (3 males and 17 females) who had neural axis abnormalities on MRI. Three of those 20 patients needed additional neurosurgical procedures before corrective surgery; the remaining underwent corrective spinal surgery without any neurosurgical operations. Magnetic resonance imaging may be beneficial for patients with presumed idiopathic scoliosis even in the absence of neurological findings and it is ideally performed from the level of the brainstem to the sacrum.


Adolescent Idiopathic Scoliosis Idiopathic Scoliosis Syringomyelia Chiari Malformation Tethered Cord Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Arai S, Ohtsuka Y, Moriya H et al (1993) Scoliosis associated with syringomyelia. Spine 18:1591–1592CrossRefPubMedGoogle Scholar
  2. 2.
    Davids JR, Chamberlin E, Blackhurst DW (2004) Indications for magnetic resonance imaging in presumed adolescent idiopathic scoliosis. J Bone Jt Surg Am 86:2187–2195Google Scholar
  3. 3.
    Do T, Fras C, Burke S et al (2001) Clinical value of routine preoperative magnetic resonance imaging in adolescent idiopathic scoliosis. J Bone Jt Surg Am 83:577–579Google Scholar
  4. 4.
    Emery E, Redondo A, Rey A (1997) Syringomyelia and Arnord Chiari in scoliosis initially classified as idiopathic: experience with 25 patients. Eur Spine J 6:158–162CrossRefPubMedGoogle Scholar
  5. 5.
    Evans SC, Edgar MA, Hall-Graggs MA et al (1996) MRI of “idiopathic” juvenile scoliosis: a prospective study. J Bone Jt Surg Br 78:314–317Google Scholar
  6. 6.
    Ferguson RL, DeVine J, Stasikelis P et al (2002) Outcomes in surgical treatment of “idiopathic-like” scoliosis associated with syringomyelia. J Spinal Disord Tech 15:301–306PubMedGoogle Scholar
  7. 7.
    Inoue M, Minami S, Nakata Y et al (2004) Preoperative MRI analysis of patients with idiopathic scoliosis. A prospective study. Spine 30:108–114Google Scholar
  8. 8.
    Kaufman BA (1997) Congenital intraspinal anomalies: spinal dysraphismembryology, pathology and treatment. In: Bridwell KH, DeWald RL (eds) The textbook of spinal surgery, vol 1, 2nd edn. Lippincott–Raven, Philadelphia, PA, p 3Google Scholar
  9. 9.
    La Grune MO, King HA (1997) Idiopathic adolescent scoliosis: indications and expectations. In: Bridwell KH, DeWald RL (eds) The textbook of spinal surgery, vol 1, 2nd edn. Lippincott-Raven, Philadelphia, PA, pp 425–450Google Scholar
  10. 10.
    Lowonowski K, King JD, Nelson MD (1992) Routine use of magnetic resonance imaging in idiopathic scoliosis patients less than eleven years of age. Spine 17(Suppl):S109–S115Google Scholar
  11. 11.
    Maiocco B, Deeney VF, Coulon R et al (1997) Adolescent idiopathic scoliosis and the presence of spinal cord abnormalities: preoperative magnetic resonance imaging analysis. Spine 22:2537–2541CrossRefPubMedGoogle Scholar
  12. 12.
    Mardjetko SM (1997) Infantile and juvenile scoliosis. In: Bridwell KH, DeWald RL (eds) The textbook of spinal surgery, vol 1, 2nd edn. Lippincott-Raven, Philadelphia, PA, pp 401–423Google Scholar
  13. 13.
    Mejia EA, Hennrikus WL, Schwend RM et al (1996) A prospective evaluation of idiopathic left thoracic scoliosis with magnetic resonance imaging. J Pediatr Orthop 16:354–358PubMedGoogle Scholar
  14. 14.
    Noordeen MHH, Taylor BA, Edgar MA (1994) Syringomyelia: a potential risk factor in scoliosis surgery. Spine 12:1406–1409Google Scholar
  15. 15.
    O’Brien MF, Lenke LG, Bridwell KH et al (1994) Pre-operative spinal canal investigation in adolescent idiopathic curves greater than 70 degrees. Spine 19:1606–1610CrossRefPubMedGoogle Scholar
  16. 16.
    Phillips WA, Hensinger RN, Kling TF Jr (1990) Management of scoliosis due to syringomyelia in childhood and adolescence. J Pediatr Orthop 10:351–354PubMedGoogle Scholar
  17. 17.
    Samuelsson L, Lindell D, Kogler H (1991) Spinal cord and brain stem anomalies in scoliosis: MR screening of 26 cases. Acta Orthop Scand 62:403–406PubMedCrossRefGoogle Scholar
  18. 18.
    Shen WJ, McDowell GS, Burke SW et al (1996) Routine preoperative MRI and SEP studies in adolescent patients with idiopathic scoliosis before spinal instrumentation and fusion. J Pediatr Orthop 16:350–353PubMedGoogle Scholar
  19. 19.
    Williams B (1990) Syringomyelia. Neurosurg Clin N Am 1:653–685PubMedGoogle Scholar
  20. 20.
    Winter RB, Lonstein JE, Heithoff KB et al (1997) Magnetic resonance imaging evaluation of the adolescent patient with idiopathic scoliosis before spinal instrumentation and fusion: a prospective, double-blinded study of 140 patients. Spine 22:855–858CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Cagatay Ozturk
    • 1
  • Selhan Karadereler
    • 1
  • Ibrahim Ornek
    • 1
  • Meric Enercan
    • 1
  • Kursat Ganiyusufoglu
    • 1
  • Azmi Hamzaoglu
    • 1
  1. 1.Istanbul Spine Center, Florence Nightingale HospitalIstanbul Bilim UniversitySisliTurkey

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