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International Orthopaedics

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06-04-2024 | Spinal Dysraphia | Original Paper

Spinal dysraphism in congenital scoliosis and kyphosis: a retrospective analysis in an Indian population

Authors: Ashok N. Johari, Amit Nemade, Arjun Dhawale, Farokh Wadia, Maulin Shah

Published in: International Orthopaedics | Issue 6/2024

Abstract

Purpose

Early recognition is crucial for occult spinal dysraphism associated with congenital spinal deformities. There is limited literature available on its occurrence in congenital scoliosis and kyphosis in the Indian population.

Methods

Our study involved a retrospective review of 247 children who presented at a single centre. We analyzed their demographics and clinical and radiological findings, which included the type of deformity, its location, vertebral anomaly, Cobb angle, and MRI findings. The deformities were categorized as congenital scoliosis or congenital kyphosis with failure of formation, failure of segmentation, or both.

Results

A total of 247 cases were examined (congenital scoliosis—229, congenital kyphosis—18). The average age was seven years (range 0.8 to 19 years, SD 4.6). The mean Cobb angle at presentation in the congenital scoliosis group was 49.4° (range 8 to 145°, SD 23.77) for those with abnormal MRI and 42.45° (range 5 to 97°, SD 20.09) for those with normal MRI. For the congenital kyphosis group, the mean K angle at presentation was 47.7° (range 14 to 110°, SD 33.33) for those with abnormal MRI and 47.36° (range 15 to 70°, SD 16.63) for those with normal MRI. Abnormal MRI results were observed in 130 of the patients (congenital scoliosis—53.7%, congenital kyphosis—38.8%). The highest incidence of abnormal MRI findings was observed in the failure of segmentation (66.6%) and mixed (65%) types. Deformities in the dorsal region had the highest incidence (61.9%). The most common dysraphism instances were diastematomyelia and tethered cord. There was a significant correlation between type of deformity and presence of dysraphism.

Conclusion

This is the largest case series of congenital scoliosis and kyphosis reported from India. We found a high incidence of occult spinal dysraphism as compared to other published series. Occult spinal dysraphism is more common in the thoracic region. Diastematomyelia followed by tethered cord was the most common anomaly observed. We recommend MRI screening of whole spine and craniovertebral junction.

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Title: Spinal dysraphism in congenital scoliosis and kyphosis: a retrospective analysis in an Indian population
Authors: Ashok N. Johari
Amit Nemade
Arjun Dhawale
Farokh Wadia
Maulin Shah
Publication date: 06-04-2024
Publisher: Springer Berlin Heidelberg
Keywords: Spinal Dysraphia
Scoliosis
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Diastematomyelia
Diastematomyelia
Dysraphism
Syringomyelia
Published in: International Orthopaedics / Issue 6/2024
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-024-06156-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Spinal dysraphism in congenital scoliosis and kyphosis: a retrospective analysis in an Indian population

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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