Ashfaq Ahmed, Abdullah Shah, Majid Zaheer, Ammar Dogar, Rizwan Akram, Amer Aziz.
Snapshot of MRI neural axis abnormalities seen in consecutive cohort of pediatric and young adult patients undergoing spinal deformity correction in tertiary care hospital setting in Pakistan.
J Pak Orthop Assoc Jan ;32(3):148-52.

Objective: To determine the frequency and types of neural axis anomalies in a consecutive cohort of paediatric and young adult patients undergoing spinal deformity correction surgery for Scoliosis. Methods: This retrospective Cohort study was conducted in Department Orthopedics and Spine Centre, Ghurki trust Teaching Hospital Lahore. The medical records of all paediatric and young adult Scoliosis patients meeting the inclusion criteria and operated for corrective surgery from 23rdJanuary 2015 to 25thDecember 2018 were reviewed. The demographic details, clinical findings, radiographs and MRI findings were noted. The frequencies of different neural axis abnormalities detected on MRI in idiopathic and congenital scoliosis were compared and statistical significance was determined by calculating P value with the help of Chi square test. Pvalue < 0.05 was considered significant. Results: A total of 87 patients with mean age13.7 ± 3.87 years were included in our study. Male patients were 29(33.3%) and female 58 (66.7%). Idiopathic Scoliosis was noted in 56 (64.4%) patients and congenital in 31(35.6%). Maximum number(n=51,58.6%) of patients had no neural axis pathologies detected on MRI. However large number (n=36,41.3%) of patients had divergent neural axis abnormalities. Syringomyelia was the commonest MRI pathology seen in 10(11.4%) patients followed by Conus in 9(10.3%), Diastomyelia in 4(4.5%), Hydromyelia in 3(3.4%), Tethered Cord in 2(2.2%), Arnold-Chiari malformation in 2(2.2%),Tonsillar Ectopia in 2 (2.29%), Dural Fault in 2(2.2%), Foramen Magnum compression in 1(1.5%) and OS Odontoideum in 1(1.14%) patient. The frequencies of these anomalies in idiopathic and congenital Scoliosis were compared and found statistically insignificant (P value >0.05) Conclusion: Large number of pediatric and young adult patients undergoing spinal deformity correction surgery for Scoliosis had neural axis anomalies detected on MRI. Syringomyelia and Conus were the most frequently noted anomalies. We recommend MRI as a mandatory pre operative investigation in all paediatric and young adult patients undergoing spinal deformity correction surgery for Scoliosis

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