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The Journal of Bone and Joint Surgery, Vol 77, Issue 1 46-53, Copyright © 1995 by Journal of Bone and Joint Surgery, Inc
Childhood scoliosis: clinical indications for magnetic resonance imaging
RM Schwend, W Hennrikus, JE Hall and JB Emans
Department of Orthopaedic Surgery, Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
We retrospectively reviewed the magnetic resonance imaging studies that had
been made for ninety-five patients who had idiopathic scoliosis. We wished
to determine if we could identify any criteria that should be met before
these studies are performed. The study group included thirty-one male
patients and sixty-four female patients. The average age at the time of the
imaging study was thirteen years (range, one to twenty-eight years). The
average curve was 41 degrees (range, 11 to 95 degrees). Fourteen patients
were seen to have an intraspinal abnormality on the imaging study: twelve
had a syrinx, one had a syrinx and an astrocytoma of the spinal cord, and
one had dural ectasia. Five of the eight patients who were less than eleven
years old and who had a left thoracic curve had an intraspinal abnormality
on the imaging study, but this combination of factors did not indicate the
need for operative intervention. Four of the intraspinal abnormalities in
the fourteen patients necessitated neurosurgical intervention; if the
criteria for obtaining the imaging study had been restricted to neck pain
and headache--particularly with exertion--and neurological findings such as
ataxia, weakness, and a cavus foot, these abnormalities would have been
diagnosed.
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