Evaluation of Associated Anomalies of the Spinal Cord in Congenital Scoliosis

Behtash, H; Ganjavian, M.S.; Ameri, E.; Mobini, B.; Vahid Tari, S.H.; Nojumi, M.

Evaluation of Associated Anomalies of the Spinal Cord in Congenital Scoliosis

Document Type : Original Article

Authors

H Behtash ¹

M.S. Ganjavian ²

E. Ameri ¹

B. Mobini ¹

S.H. Vahid Tari ³

M. Nojumi ⁴

¹ Associate Professor of Orthopedic Surgery, Iran University of Medical Sciences and Health Services, Hazrate Rasool Hospital, Tehran, Iran

² Assistant Professor of Orthopedic Surgery, Iran University of Medical Sciences and Health Services, Shafa Yahyaian Hospital, Tehran, Iran

³ Spinal Surgery Resident, Shafa Yahyaian Hospital, Tehran, Iran

⁴ Associate Professor of Social Medicine, Iran University of Medical Sciences and Health Services, Shafa Yahyaian Hospital, Tehran, Iran

Abstract

Introduction & Objective: Congenital scoliosis is among the most challenging deformities for treatment and even more is the presence of underlying cord anomalies. The result will be catastrophic if we can not predict underlying cord anomalies prior to surgery. The goal of this study is to find the clues to this puzzle. Materials & Methods: For 381 registered patients with congenital scoliosis, physical exam, plane x-ray, and intra-canal imaging (MRI or myelography) were done to assess the possible underlying anomalies . Then correlation of cord anomaly with other anomalies in other part of body was considered in SPSS software and Paired t-test. Results: Cord anomalies was seen in 83 patients (21.8%) and neurologic deficit found in physical exam in 26 patients (6.8%). Abnormal neurologic findings correlated with cord anomaly (P-value = 0.0001). Skin mark (hair patch, dimple, nevi, etc) had positive correlation with cord anomaly (P-value = 0.001). Type III congenital scoliosis had positive correlation with cord anomaly (P-value = 0.01). Conclusions: It is suggested to be careful with neurologic deficit in physical exam, skin mark and type III congenital scoliosis when preparing the patients for surgical treatment of scoliosis. We should remember that normal physical examination dose not rule out cord anomaly.

Keywords

Congenital Scoliosis

Intra-Spinal Abnormality