Preoperative Evaluation of Adolescent Idiopathic Scoliosis: The Relevance of Routine Magnetic Resonance Imaging

TL;DR

This study examines the usefulness of routine MRI scans before surgery for adolescent scoliosis patients to detect hidden spinal issues.

Contribution

The study provides evidence supporting the use of routine MRI for preoperative evaluation in AIS patients.

Findings

10.4% of patients had neural axis abnormalities detected by MRI.

Abnormal MRI findings were more common in males and associated with increased thoracic kyphosis.

No significant differences were found in other measured parameters.

Abstract

Introduction

The evidence for using preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with adolescent idiopathic scoliosis (AIS) is not well established. However, it is routine to perform whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction in our center to detect occult neural axis abnormalities that may not present with neurological symptoms but could influence surgical planning and safety.

Method

A retrospective single-center and descriptive evaluation of the medical records of AIS patients aged 10 to 18 who were admitted for surgical treatment at our institution between 2017 and 2022 to evaluate the value of the routine preoperative MRI. Descriptive statistics were utilized to analyze the data. Independent t-tests and chi-square tests (X²) or Fisher's exact tests were employed to compare groups as appropriate.

Results

Out of 106 patients evaluated, 10 patients (9.4%) were found to have neural axis abnormalities. Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in the other parameters that were measured.

Conclusion

Even in the absence of neurological symptoms to identify any abnormalities of the neural axis, MRI may be useful in making decisions for the surgical treatment of AIS patients, particularly for those with risk factors such as male sex or exaggerated kyphosis.

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