Occult intraspinal abnormalities and congenital scoliosis

Abstract

BACKGROUND: Congenital scoliosis occurs because of either the failure of formation or the failure of segmentation or both. Evaluation of the incidence and the types of occult intraspinal abnormalities in congenital scoliosis is the subject of this study.

METHODS: During a period of 29 years, 103 patients with congenital scoliosis were studied. MRI was used in 46 patients, myelography or CT myelography was used in 64 patients and both MRI and myelography or CT myelography were used in 7 patients for intraspinal abnormalities.

RESULTS: In the MRI group, among the 46 patients, 19 patients (41.3%) had intraspinal abnormalities consisting syringomyelia in 9 (19.5%) diastematomyelia in 8 (17.4%), tethered cord syndrome in 6 (13%), low conus in 5 (10.8%) and diplomyelia in 3 (6.5%) of the patients. In the myelography group, among the 64 patients, 17 (26.5%) had intraspinal abnormalities and diastematomyelia was the most common one found in 14 (21.8%) patients.

CONCLUSIONS: Intraspinal abnormalities are frequent in congenital scoliosis. Syringomyelia may be associated with congenital scoliosis. In congenital scoliosis, rib fusion may be an indicator of intraspinal abnormalities in MRI. A significant difference between clinical findings and intraspinal anomalies (P<0.05) was noted. Moreover, we believe that total spinal MRI with coronal, sagittal and axial views is a valuable tool in determining the intraspinal abnormalities in congenital scoliosis. This method is highly recommended for detection and neurosurgical intervention before corrective surgeries.

KEY WORDS: Congenital scoliosis, intraspinal abnormalities, diastematomyelia.