European Spine Journal

, Volume 22, Issue 2, pp 355–359 | Cite as

The use of routine preoperative magnetic resonance imaging in identifying intraspinal anomalies in patients with idiopathic scoliosis: a 10-year review

  • Rohit SinghalEmail author
  • Daniel C. Perry
  • Seema Prasad
  • Neil T. Davidson
  • Colin E. Bruce
Original Article



This study sought to quantify the frequency of previously unidentified spinal cord anomalies identified by routine preoperative magnetic resonance imaging (MRI), in patients planned for surgical scoliosis correction.


Our study group comprised 206 patients with idiopathic scoliosis who underwent deformity correction from 1998 to 2008. Clinical records of all the patients were retrospectively reviewed to ascertain the proportion having a neural abnormality on preoperative MRI scan.


Twenty of 206 patients (9.7 %) were diagnosed with an unexpected intraspinal anomaly on routine preoperative MRI. In all cases, a neurosurgical opinion was sought prior to further intervention. Of the 20 patients, 11 underwent a neurosurgical procedure (de-tethering of cord, decompression of Chiari, decompression of syrinx). There was no statistically significant difference between the group of patients who had intrinsic spinal cord anomalies on preoperative MRI and those did not have a cord abnormality with regard to age at presentation, gender, side of dominant curve and degree of curve (p < 0.05).


The high frequency of spinal cord abnormalities unidentified by preoperative neurological examination, and the frequent need for subsequent neurosurgical intervention, suggests that MRI assessment prior to deformity correction is important in the management of idiopathic scoliosis.


Idiopathic scoliosis Intraspinal anomalies Preoperative MRI 


Conflict of interest



  1. 1.
    Schwend RM, Hennrikus W, Hall JE, Emans JB (1995) Childhood scoliosis: clinical indications for magnetic resonance imaging. J Bone Joint Surg Am 77:46–53PubMedGoogle Scholar
  2. 2.
    Diab M, Landman Z, Lubicky J, Dormans J, Erickson M, Richards BS, Members of the Spinal Deformity Study Group (2011) Use and outcome of MRI in the surgical treatment of adolescent idiopathic scoliosis. Spine 36(8):667–671PubMedCrossRefGoogle Scholar
  3. 3.
    Samuelsson L, Lindell D, Kogler H (1991) Spinal cord and brain stem anomalies in scoliosis. MR screening of 26 cases. Acta Orthop Scand 62(5):403–406PubMedCrossRefGoogle Scholar
  4. 4.
    Lewonowski K, King JD, Nelson MD (1992) Routine use of magnetic resonance imaging in idiopathic scoliosis patients less than eleven years of age. Spine 17(6 Suppl):109–116CrossRefGoogle Scholar
  5. 5.
    Evans SC, Edgar MA, Hall-Craggs MA, Powell MP, Taylor BA, Noordeen HH (1996) MRI of ‘idiopathic’ juvenile scoliosis. A prospective study. J Bone Joint Surg Br 78(2):314–317PubMedGoogle Scholar
  6. 6.
    Maiocco B, Deeney VF, Coulon R, Parks PF Jr (1997) Adolescent idiopathic scoliosis and the presence of spinal cord abnormalities. Preoperative magnetic resonance imaging analysis. Spine 22(21):2537–2541PubMedCrossRefGoogle Scholar
  7. 7.
    Huebert HT, MacKinnon WB (1969) Syringomyelia and scoliosis. J Bone Joint Surg Br 51(2):338–343PubMedGoogle Scholar
  8. 8.
    Charry O, Koop S, Winter R, Lonstein J, Denis F, Bailey W (1994) Syringomyelia and scoliosis: a review of twenty-five pediatric patients. J Pediatr Orthop 14(3):309–317PubMedCrossRefGoogle Scholar
  9. 9.
    Fujimori T, Iwasaki M, Nagamoto Y, Sakaura H, Oshima K, Yoshikawa H (2010) The utility of superficial abdominal reflex in the initial diagnosis of scoliosis: a retrospective review of clinical characteristics of scoliosis with syringomyelia. Scoliosis 26(5):17CrossRefGoogle Scholar
  10. 10.
    Zadeh HG, Sakka SA, Powell MP, Mehta MH (1995) Absent superficial abdominal reflexes in children with scoliosis. An early indicator of syringomyelia. J Bone Joint Surg Br 77(5):762–767PubMedGoogle Scholar
  11. 11.
    Rajasekaran S, Kamath V, Kiran R, Shetty AP (2010) Intraspinal anomalies in scoliosis: an MRI analysis of 177 consecutive scoliosis patients. Indian J Orthop 44(1):57–63PubMedCrossRefGoogle Scholar
  12. 12.
    Inoue M, Minami S, Nakata Y, Otsuka Y, Takaso M, Kitahara H, Tokunaga M, Isobe K, Moriya H (2005) Preoperative MRI analysis of patients with idiopathic scoliosis: a prospective study. Spine 30(1):108–114PubMedGoogle Scholar
  13. 13.
    Pahys JM, Samdani AF, Betz RR (2009) Intraspinal anomalies in infantile idiopathic scoliosis: prevalence and role of magnetic resonance imaging. Spine 34(12):E434–E438PubMedCrossRefGoogle Scholar
  14. 14.
    Morcuende JA, Dolan LA, Vazquez JD, Jirasirakul A, Weinstein SL (2004) A prognostic model for the presence of neurogenic lesions in atypical idiopathic scoliosis. Spine 29(1):51–58PubMedCrossRefGoogle Scholar
  15. 15.
    Gupta P, Lenke LG, Bridwell KH (1998) Incidence of neural axis abnormalities in infantile and juvenile patients with spinal deformity: is a magnetic resonance image screening necessary? Spine 23(2):206–210PubMedCrossRefGoogle Scholar
  16. 16.
    Wu L, Qiu Y, Wang B, Zhu ZZ, Ma WW (2010) The left thoracic curve pattern: a strong predictor for neural axis abnormalities in patients with “idiopathic” scoliosis. Spine 35(2):182–185PubMedCrossRefGoogle Scholar
  17. 17.
    Davids JR, Chamberlin E, Blackhurst DW (2004) Indications for magnetic resonance imaging in presumed adolescent idiopathic scoliosis. J Bone Joint Surg Am 86:2187–2195PubMedGoogle Scholar
  18. 18.
    Noordeen MHH, Taylor BA, Edgar MA (1994) Syringomyelia: a potential risk factor in scoliosis surgery. Spine 19(12):1406–1409PubMedCrossRefGoogle Scholar
  19. 19.
    Yeom JS, Lee CK, Park KW, Lee JH, Lee DH, Wang KC, Chang BS (2007) Scoliosis associated with syringomyelia: analysis of MRI and curve progression. Eur Spine J 16(10):1629–1635PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Rohit Singhal
    • 1
    Email author
  • Daniel C. Perry
    • 1
  • Seema Prasad
    • 2
  • Neil T. Davidson
    • 1
  • Colin E. Bruce
    • 1
  1. 1.Department of OrthopaedicsAlder Hey Children’s HospitalLiverpoolUK
  2. 2.Department of OrthopaedicsWarrington District General HospitalWarringtonUK

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