Abstract
Statement of purpose: To profile the neurological lesions associated with scoliosis, evaluate the role of preoperative MRI and determine the proportion of patients requiring surgery for an intradural lesion.
Methods: The records of patients undergoing surgery to treat scoliosis over a 5 year period were reviewed as part of this retrospective single centre study.
Results: 1926 patients underwent 2714 procedures to treat scoliosis. 45 patients from this cohort were referred for an opinion regarding at least one of the following neural axis abnormalities: Syrinx (47%); Chiari malformation and cerebellar ectopia (40%); tethered cord (13%); persistent central canal (9%); diastematomyelia (7%); neurofibromata (7%); syndromes other than neurofibromatosis (7%); tumours (4%) and vascular lesions (2%).
18 patients underwent surgery to treat a neural axis lesion: Foramen magnum decompression (12); cord untethering (4) and the surgical treatment of diastematomyelia (2).
Conclusions: The authors believe their series to be the largest to date.
Preoperative MRI scans should extend from the cranio-cervical junction to the sacrum, reflecting the potential locations of neural axis lesions.
Radiologists present at units treating scoliosis should be able to identify both commonly occurring lesions such syrinx and intradural pathology.
A significant proportion of patients required surgery to treat their neural axis lesions. Centres treating patients with scoliosis should therefore have the necessary facilities to treat not only scoliosis but also its associated intradural spinal lesions.
Ethics approval: None Audit
Interest Statement: None
Correspondence should be addressed to BASS/BCSS c/o BOA, at the Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London, WC2A 3PE, England.
