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European Spine Journal

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01-02-2019 | Original Article

Intraspinal neural axis abnormalities in severe spinal deformity: a 10-year MRI review

Authors: Ying Zhang, Jingming Xie, Yingsong Wang, Ni Bi, Tao Li, Jie Zhang, Zhi Zhao, Hua Ou, Siyuan Liu

Published in: European Spine Journal | Issue 2/2019

Abstract

Purpose

Documents indicated that the average prevalence of intraspinal neural axis abnormalities (INAAs) in presumed idiopathic scoliosis (PIS) patients was about 17.7%. However, paucity study focuses on the incidence of INAAs in severe spinal deformity (SSDs). In this study, we investigate the incidence of intraspinal neural axis abnormalities (IINAAs) and the clinical relevance in SSD at a single center.

Methods

All the patients with SSDs admitted for spinal surgery were evaluated from 2003 to 2014. Inclusion criteria: patients who present with coronal Cobb over 90° (and/or the sagittal Cobb ≥ 90°); patients with whole spine magnetic resonance imaging (MRI) done preoperatively; and patients with documented clinical findings preoperatively. Exclusion criteria: ankylosing spondylitis, adult onset scoliosis, scoliosis secondary to bone destruction, and spinal dysraphism.

Results

101 patients fulfilled the criteria were included. 43 patients were detected with INAAs (42.6%, 43/101). The most common INAAs was syrinx (S) (16/43, 37.2%). Of which, 43.7% (7/16), 37.5% (6/16), and 18.7% (3/16) were spindle, slit, and swelling types, respectively. Most of them were located in thoracic (6/16, 37.5%) and cervical (5/16, 31.3%) region. MRI revealed Chiari malformation with syringomyelia (C + S) in ten patients (10/43, 23.2%), Chiari malformation (C) in 6 patients (6/43, 13.9%) and others in 11 patients (11/43, 25.6%). As to the etiology, most patients with INAAs were PIS (34/43, 79.1%). On clinical examination, 16 of 101 patients (16/101, 15.8%) had abnormal neurologic signs. 15 of 16 patients (15/16, 93.7%) with abnormal neurologic signs had INAAs on MRI. On the other hand, 28 of 43 patients (28/43, 65.1%) with INAAs on MRI presented neurologically intact. 28 of 85 patients (28/85, 32.9%) with neurologically intact were detected with INAAs on MRI.

Conclusion

The incidence of INAAs in SSDs was 42.6%. 65.1% of them present intact neurologic status. The most common neural anomaly was syrinx. Preoperative whole spine MRI must be beneficial for SSDs even in the absence of neurological findings.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Intraspinal neural axis abnormalities in severe spinal deformity: a 10-year MRI review
Authors: Ying Zhang
Jingming Xie
Yingsong Wang
Ni Bi
Tao Li
Jie Zhang
Zhi Zhao
Hua Ou
Siyuan Liu
Publication date: 01-02-2019
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 2/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-5522-3

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Intraspinal neural axis abnormalities in severe spinal deformity: a 10-year MRI review

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Graphical abstract

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