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The correlation between coronal balance and neuroaxial abnormalities detected on MRI in adolescent idiopathic scoliosis

European Spine Journal volume 21, pages 1106–1110 (2012)Cite this article

Abstract

Introduction

The indications for magnetic resonance imaging in presumed adolescent idiopathic scoliosis (AIS) have not been established, with some studies suggesting that rates of spinal cord abnormalities are low and question the use of the routine MRI in AIS.

Objective

Given the restraints on MRI resources the authors performed a retrospective audit to see if the presence of coronal or sagittal misbalance–balance could be used as a surrogate marker for the presence of spinal cord abnormalities in this patient group and hence reduce the need for unnecessary MRI scans.

Methods

We performed a retrospective review of imaging of patients with AIS at our centre over a 2-year-period. All MRI scans were reported by the senior author and the presence of spinal cord abnormalities noted. All plain films were assessed by a senior SpR and ST2 orthopaedic surgeons for Cobb angle, coronal balance, sagittal balance and Lenke classification.

Results

A total of 171 patients were identified with AIS. Of these, a total of 15 patients (9%) were found to have neural axis anomalies on MRI including syringomyelia, Chiari malformations and dural ectasia. The average Cobb angle was 44.9° with coronal balance varying from 67.2 mm left to 40.2 mm right. Sagittal balance varied from 125 mm negative to 83 mm positive. No correlation was found between coronal/sagittal misbalance and the presence of neural axis anomalies.

Conclusions

Our audit demonstrates that neither coronal nor sagittal misbalance should be used as an indicator of neural axis abnormalities.

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Affiliations

  1. Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK

    Robert S. Lee, Daniel W. Reed & Asif Saifuddin

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  1. Robert S. Lee
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  2. Daniel W. Reed
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  3. Asif Saifuddin
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Correspondence to Robert S. Lee.

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Lee, R.S., Reed, D.W. & Saifuddin, A. The correlation between coronal balance and neuroaxial abnormalities detected on MRI in adolescent idiopathic scoliosis. Eur Spine J 21, 1106–1110 (2012). https://doi.org/10.1007/s00586-012-2175-5

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  • DOI: https://doi.org/10.1007/s00586-012-2175-5

Keywords

  • Adolescent idiopathic scoliosis
  • MRI
  • Coronal balance
  • Sagittal balance
  • Neural axis abnormalities