The prevalence of intraspinal neuro-axis abnormalities in juvenile patients with “presumed idiopathic” scoliosis and the analysis of associated indicators
Zhang Wen1, Sun Chao1, Yi Jin1, Yang Yelin1, Liu Xinhui1, Zhu Zezhang2
1Department of Orthopedics, the Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 211100, China; 2Department of Spinal Surgery, the Drum Tower Hospital of Nanjing University of Medical School, Nanjing 210008, China
Abstract：Objective To investigate the incidence and type of intraspinal neuro-axis abnormalities in juvenile patients with “presumed idiopathic” scoliosis and to analyze the associated radiographic and clinical characteristics.Methods Four hundred and six cases of children with "esthetic" scoliosis in the spine surgery outpatient clinic of Nanjing Gulou Hospital from January 2012 to October 2016 were retrospectively analyzed. Total spinal MRI, standing full spine positive lateral radiograph and related clinical features were analyzed. There were 128 males and 278 females with an average age of (8.1±1.8) years. The type and incidence of spinal canal malformations were analyzed and counted after MRI scan. Patients were grouped into two cohorts according to the presence of neural axis abnormalities. Radiographic parameters including curve magnitude, direction of main curve, curve pattern, location of apex, degree of thoracic kyphosis, and span of curve were recorded and compared between the two groups.Results Of the 406 children,77 patients (18.7%) had different types of spinal cord malformations: of which 36 patients had isolated Arnold-Chiari malformation, 14 patients had isolated syringomyelia,11 patients had Arnold-Chiari malformation combined with syringomyelia, 4 patients had tethered cord combined with diastematomyelia, 3 patients had spinal cord fissure, 3 patients had spinal cord occupying lesions, 2 patients had isolated tethered cord disease, 2 patients had syringomyelia and tethered cord combined with diastematomyelia, one patient had tethered cord combined with spinal core occupying lesion, and one patient had syringomyelia combined with spinal cord occupying lesion. Compared with the non-abnormal group, the male 50.6%(39/77), left chest 19.5%(15/77), and right lumbar flexion ratios 7.8%(6/77) were higher in the deformed group 27.1(89/329), 7.0%(23/329), 0.6%(2/329)(χ2=17.387, 4.811, 15.826, all P values＜0.05).Conclusions The incidence of neural axis abnormalities in patients with the presumed JIS is 18.7%. There is a great need for children with JIS to have a full spinal MRI scan in order to detect spinal canal malformations as early as possible, especially in males with left thoracic curve or right lumbar curve.
张文, 孙超, 易进, 杨业林, 刘新晖, 朱泽章. 少儿型“特发性”脊柱侧凸椎管内神经轴畸形发生率及相关临床特征分析[J]. 中华解剖与临床杂志, 2019, 24(3): 263-267.
Zhang Wen, Sun Chao, Yi Jin, Yang Yelin, Liu Xinhui, Zhu Zezhang. The prevalence of intraspinal neuro-axis abnormalities in juvenile patients with “presumed idiopathic” scoliosis and the analysis of associated indicators. Chinese Journal of Anatomy and Clinics, 2019, 24(3): 263-267.
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2019, Vol. 24 
