Scoliosis MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rohan A. Bhimani, M.B.B.S., D.N.B., M.Ch.[2]

Overview

M.R.I. is the gold standard test indicated for neuromuscular and congenital scoliosis. M.R.I. is seldom used for adolescent idiopathic scoliosis. However, in some unusual situations with adolescent idiopathic scoliosis, M.R.I. is indicated.

M.R.I.

  • M.R.I. is the diagnostic test indicated for neuromuscular and congenital scoliosis.[1][2][3][4]15466727
  • M.R.I. is seldom used for adolescent idiopathic scoliosis.
  • However, in some atypical situations with adolescent idiopathic scoliosis, M.R.I. is indicated.
  • M.R.I. is used with increasing frequency to evaluate patients with an unusual curve pattern or alarming clinical manifestations.

Chief Indications for M.R.I.

  • Congenital neuropathic abnormality such as arnold-chiari malformation, tethered cord, and dysraphism - related anomalies.
  • Dysplasia such as neurofibromatosis, osteogenesis imperfecta, and marfan's syndrome.
  • Pain suggestive of bone tumor, infection, and intervertebral disc herniation.
  • Neurologic deterioration with abnormality at electroneurography or evoked electromyography.
  • Idiopathic scoliosis with specific clinical or neurological features.

Indications of M.R.I. for Idiopathic Scoliosis

  • Clinical features
    • Age < 10 years
    • Signs of neurological deterioration
    • Rapid progression
    • Foot deformity
    • Back pain, neck pain, headache
  • Radiological features
    • Curve type commonly associated with neuropathy such as:
      • Left thoracic
      • Double thoracic
      • Triple major
      • Short segment
      • Long right thoracic curve
      • Severe curve after skeletal maturity
    • Presence of intramedullary non osseous lesions with features such as:
      • Wide spinal canal
      • Thin pedicle
      • Wide neural foramina

References

  1. Cassar-Pullicino VN, Eisenstein SM (2002). "Imaging in scoliosis: what, why and how?". Clin Radiol. 57 (7): 543–62. PMID 12096851.
  2. Isu T, Chono Y, Iwasaki Y, Koyanagi I, Akino M, Abe H; et al. (1992). "Scoliosis associated with syringomyelia presenting in children". Childs Nerv Syst. 8 (2): 97–100. PMID 1591754.
  3. Williams B (1979). "Orthopaedic features in the presentation of syringomyelia". J Bone Joint Surg Br. 61-B (3): 314–23. PMID 158024.
  4. Do T, Fras C, Burke S, Widmann RF, Rawlins B, Boachie-Adjei O (2001). "Clinical value of routine preoperative magnetic resonance imaging in adolescent idiopathic scoliosis. A prospective study of three hundred and twenty-seven patients". J Bone Joint Surg Am. 83-A (4): 577–9. PMID 11315788.

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