TY - JOUR
T1 - MRI utilization and rates of abnormal pretreatment MRI findings in early-onset scoliosis
T2 - review of a global cohort
AU - The Pediatric Spine Study Group
AU - Williams, Brendan A.
AU - McClung, Anna
AU - Blakemore, Laurel C.
AU - Shah, Suken A.
AU - Pawelek, Jeff B.
AU - Sponseller, Paul D.
AU - Parent, Stefan
AU - Emans, John B.
AU - Sturm, Peter F.
AU - Yaszay, Burt
AU - Akbarnia, Behrooz A.
N1 - Publisher Copyright:
© 2020, Scoliosis Research Society.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Study design: Retrospective review Objectives: To report the frequency of pretreatment magnetic resonance imaging (MRI) utilization and rates and types of intra-spinal abnormalities identified on MRI in patients with early-onset scoliosis (EOS). Summary of background data: MRI can help identify spinal cord abnormalities in patients with EOS. Methods: We reviewed data from patients enrolled from 1993–2018 in an international EOS registry. Patients with incomplete/unverifiable data and those with spinal deformities secondary to infection or tumor were excluded, leaving 1343 patients for analysis. Demographic characteristics, pretreatment major curve magnitude, treatment type, and MRI findings were analyzed. Patients were categorized by EOS type (congenital, idiopathic, neuromuscular, syndromic), pretreatment MRI utilization, and presence of intra-spinal abnormality on MRI. Univariate testing and multivariate logistic regression were performed to identify demographic, radiographic, and clinical predictors of MRI utilization and abnormal MRI findings. Results: MRI was used in 836 patients (62%). Pretreatment MRI utilization rates ranged from 42% in neuromuscular EOS to 74% in congenital EOS. Prevalence of abnormal MRI findings was 24% overall, ranging from 13% in patients with idiopathic EOS to 39% in neuromuscular EOS. Compared with white/Caucasian patients, Asian/Asian-American patients had higher odds of MRI utilization and abnormal MRI findings. Treatment type, pretreatment major curve magnitude, age at MRI, and age at treatment were not associated with abnormal MRI findings. Overall, 249 abnormalities were identified in 197 patients. The most common findings were syrinx and tethered cord. Syrinx with Chiari malformation was the most frequent combination of abnormal findings. Conclusion: In the two-thirds of patients who underwent MRI before EOS treatment, findings were abnormal in 24%. EOS type and race/ethnicity were associated with both MRI utilization and abnormal findings. The most frequent abnormalities were syrinx and tethered cord, and the type of abnormalities appeared to differ by EOS type. Level of evidence: Prognostic, Level III.
AB - Study design: Retrospective review Objectives: To report the frequency of pretreatment magnetic resonance imaging (MRI) utilization and rates and types of intra-spinal abnormalities identified on MRI in patients with early-onset scoliosis (EOS). Summary of background data: MRI can help identify spinal cord abnormalities in patients with EOS. Methods: We reviewed data from patients enrolled from 1993–2018 in an international EOS registry. Patients with incomplete/unverifiable data and those with spinal deformities secondary to infection or tumor were excluded, leaving 1343 patients for analysis. Demographic characteristics, pretreatment major curve magnitude, treatment type, and MRI findings were analyzed. Patients were categorized by EOS type (congenital, idiopathic, neuromuscular, syndromic), pretreatment MRI utilization, and presence of intra-spinal abnormality on MRI. Univariate testing and multivariate logistic regression were performed to identify demographic, radiographic, and clinical predictors of MRI utilization and abnormal MRI findings. Results: MRI was used in 836 patients (62%). Pretreatment MRI utilization rates ranged from 42% in neuromuscular EOS to 74% in congenital EOS. Prevalence of abnormal MRI findings was 24% overall, ranging from 13% in patients with idiopathic EOS to 39% in neuromuscular EOS. Compared with white/Caucasian patients, Asian/Asian-American patients had higher odds of MRI utilization and abnormal MRI findings. Treatment type, pretreatment major curve magnitude, age at MRI, and age at treatment were not associated with abnormal MRI findings. Overall, 249 abnormalities were identified in 197 patients. The most common findings were syrinx and tethered cord. Syrinx with Chiari malformation was the most frequent combination of abnormal findings. Conclusion: In the two-thirds of patients who underwent MRI before EOS treatment, findings were abnormal in 24%. EOS type and race/ethnicity were associated with both MRI utilization and abnormal findings. The most frequent abnormalities were syrinx and tethered cord, and the type of abnormalities appeared to differ by EOS type. Level of evidence: Prognostic, Level III.
KW - Early-onset scoliosis
KW - Infantile idiopathic scoliosis
KW - Juvenile idiopathic scoliosis
KW - Magnetic resonance imaging
KW - Neural axis abnormalities
KW - Prevalence
UR - http://www.scopus.com/inward/record.url?scp=85084146563&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85084146563&partnerID=8YFLogxK
U2 - 10.1007/s43390-020-00115-3
DO - 10.1007/s43390-020-00115-3
M3 - Article
C2 - 32333333
AN - SCOPUS:85084146563
SN - 2212-134X
VL - 8
SP - 1099
EP - 1107
JO - Spine deformity
JF - Spine deformity
IS - 5
ER -