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Scoliosis and Spinal Disorders
Published in: Scoliosis and Spinal Disorders 1/2017

Open Access 01-12-2017 | Research

Is a persistent central canal a risk factor for neurological injury in patients undergoing surgical correction of scoliosis?

Authors: Steven Kyriacou, Yuen Man, Karen Plumb, Matthew Shaw, Kia Rezajooi

Published in: Scoliosis and Spinal Disorders | Issue 1/2017

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Abstract

Background

Scoliosis patients with associated syringomyelia are at an increased risk of neurological injury during surgical deformity correction. The syrinx is therefore often addressed surgically prior to scoliosis correction to minimize this risk. It remains unclear if the presence of a persistent central canal (PCC) within the spinal cord also poses a similar risk. The aim of this study is to determine whether there is any evidence to suggest that patients with a PCC are also at a higher risk of neurological injury during surgical scoliosis correction.

Methods

Eleven patients with a PCC identified on pre-operative magnetic resonance imaging who had undergone correction of adolescent idiopathic scoliosis (AIS) over a 7-year study period at our institution were retrospectively identified. The incidence of abnormal intra-operative spinal cord monitoring (SCM) traces in this group was in turn compared against 44 randomly selected age- and sex-matched controls with no PCC who had also undergone surgical correction of AIS during the study period. Fisher’s exact test was applied to determine whether there was a significant difference in the incidence of abnormal intra-operative SCM traces between the two groups.

Results

Statistical analysis demonstrated no significant difference in the incidence of abnormal intra-operative SCM signal traces between the PCC group and the control group.

Conclusions

This study demonstrates no evidence to suggest a PCC increases the risk of neurological complications during scoliosis correction. We therefore suggest that surgical correction of scoliosis in patients with a PCC can be carried out safely with routine precautions.
Literature
1.
El-Hawary R, et al. Spinal cord monitoring in patients with spinal deformity and neural axis abnormalities: a comparison with adolescent idiopathic scoliosis patients. Spine (Phila Pa 1976). 2006;31(19):E698–706.CrossRef
2.
Sansur CA, et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976). 2011;36(9):E593–7.CrossRef
3.
Winter RB. Neurologic safety in spinal deformity surgery. Spine (Phila Pa 1976). 1997;22(13):1527–33.CrossRef
4.
Gupta P, Lenke LG, Bridwell KH. Incidence of neural axis abnormalities in infantile and juvenile patients with spinal deformity. Is a magnetic resonance image screening necessary? Spine (Phila Pa 1976). 1998;23(2):206–10.CrossRef
5.
Winter RB, et al. Magnetic resonance imaging evaluation of the adolescent patient with idiopathic scoliosis before spinal instrumentation and fusion. A prospective, double-blinded study of 140 patients. Spine (Phila Pa 1976). 1997;22(8):855–8.CrossRef
6.
Mooney JF 3rd, et al. Neurologic risk management in scoliosis surgery. J Pediatr Orthop. 2002;22(5):683–9.PubMed
7.
Ozerdemoglu RA, Transfeldt EE, Denis F. Value of treating primary causes of syrinx in scoliosis associated with syringomyelia. Spine (Phila Pa 1976). 2003;28(8):806–14.
8.
Noordeen MH, Taylor BA, Edgar MA. Syringomyelia. A potential risk factor in scoliosis surgery. Spine (Phila Pa 1976). 1994;19(12):1406–9.CrossRef
9.
Nordwall A, Wikkelso C. A late neurologic complication of scoliosis surgery in connection with syringomyelia. Acta Orthop Scand. 1979;50(4):407–10.CrossRefPubMed
10.
Petit-Lacour MC, et al. Visibility of the central canal on MRI. Neuroradiology. 2000;42(10):756–61.CrossRefPubMed
11.
Magge SN, et al. Idiopathic syrinx in the pediatric population: a combined center experience. J Neurosurg Pediatr. 2011;7(1):30–6.CrossRefPubMed
12.
Holly LT, Batzdorf U. Slitlike syrinx cavities: a persistent central canal. J Neurosurg. 2002;97(2 Suppl):161–5.PubMed
13.
Roser F, et al. Defining the line between hydromyelia and syringomyelia. A differentiation is possible based on electrophysiological and magnetic resonance imaging studies. Acta Neurochir. 2010;152(2):213–9. discussion 219CrossRefPubMed
14.
Kasantikul V, Netsky MG, James AE Jr. Relation of age and cerebral ventricle size to central canal in man. Morphological analysis. J Neurosurg. 1979;51(1):85–93.CrossRefPubMed
15.
Milhorat TH, Kotzen RM, Anzil AP. Stenosis of central canal of spinal cord in man: incidence and pathological findings in 232 autopsy cases. J Neurosurg. 1994;80(4):716–22.CrossRefPubMed
16.
Yasui K, et al. Age-related morphologic changes of the central canal of the human spinal cord. Acta Neuropathol. 1999;97(3):253–9.CrossRefPubMed
17.
18.
Sponseller PD. Syringomyelia and Chiari I malformation presenting with juvenile scoliosis as sole manifestation. J Spinal Disord. 1992;5(2):237–9. discussion 239-44CrossRefPubMed
19.
Emery E, Redondo A, Rey A. Syringomyelia and Arnold Chiari in scoliosis initially classified as idiopathic: experience with 25 patients. Eur Spine J. 1997;6(3):158–62.CrossRefPubMedPubMedCentral
20.
Hanieh A, et al. Syringomyelia in children with primary scoliosis. Childs Nerv Syst. 2000;16(4):200–2.CrossRefPubMed
21.
Tomlinson RJ Jr, et al. Syringomyelia and developmental scoliosis. J Pediatr Orthop. 1994;14(5):580–5.CrossRefPubMed
22.
23.
Phillips WA, Hensinger RN, Kling TF Jr. Management of scoliosis due to syringomyelia in childhood and adolescence. J Pediatr Orthop. 1990;10(3):351–4.CrossRefPubMed
24.
Bradley LJ, et al. The outcomes of scoliosis surgery in patients with syringomyelia. Spine (Phila Pa 1976). 2007;32(21):2327–33.CrossRef
25.
Fischbein NJ, et al. The “presyrinx” state: a reversible myelopathic condition that may precede syringomyelia. AJNR Am J Neuroradiol. 1999;20(1):7–20.PubMed
26.
Wilson-Holden TJ, et al. Efficacy of intraoperative monitoring for pediatric patients with spinal cord pathology undergoing spinal deformity surgery. Spine (Phila Pa 1976). 1999;24(16):1685–92.CrossRef
Metadata
Title
Is a persistent central canal a risk factor for neurological injury in patients undergoing surgical correction of scoliosis?
Authors
Steven Kyriacou
Yuen Man
Karen Plumb
Matthew Shaw
Kia Rezajooi
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Scoliosis and Spinal Disorders / Issue 1/2017
Electronic ISSN: 2397-1789
DOI
https://doi.org/10.1186/s13013-017-0133-z

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