Spondilolisthesis: 7.2% (13). ⢠CS: 1, TS: 0, LS: 6 (p=0.002). ⢠Diastematomyelia (split cord): 5.5% (10). ⢠CS: 2, TS: 4, LS: 4 (p>0.05). ⢠Tethered cord: 5.5% (10).
S 62
Spinal Pathologies With Scoliosis Mehmet B.Balioglu, Osman Cimen, M.Akif Kaygusuz Baltalimani Bone Disease Teaching Hospital Istanbul, Turkey
CONCURRENT SESSIONS - S62
Spinal Pathologies with Scoliosis Author
Relationships Disclosed
Mehmet Bulent Balioglu
No Relationship
Osman Cimen
No Relationship
M.Akif Kaygusuz
No Relationship
Introduction •The objective of our study was to identify the frequency and location of scoliotic pathologies using MRI.
Method • Between 2000-2010, 402 patients diagnosed; • Idiopathic, • Congenital, • Neuromuscular and • Syndromic scoliosis were retrospectively evaluated to identify the frequency and location: • Cervical, • Thorasic, • Lumbar areas of related pathologies. Diagnosis
Number
Gender Concamitant Age Surgery F M Pathologies (%) 236 54 14.9 (11-22) 71 52 (17.9%)
CS
TS
LS
9
25
21
Idiopathic Scoliosis
290
Congenital Scoliosis
48
31 17
15 (5-35)
43 (89.5%)
5
15
27
23
Neuromuscular S.
44
30 14
15.3 (4-30)
30 (68.1%)
5
15
15
17
Syndromic Scoliosis
20
6
14 (10-18)
12 (60%)
4
5
7
-
Total
402
14
303 99 14.8 85 137 (34%) 44 (24.5%) 74 (41.3%) 61 (34%) Frequency and location of scoliotic pathologies
Results • 290 patients were diagnosed as idiopathic scoliosis (IS): • Gender: 236 F, 54 M • Age: 14.9 y (11-22) • Concomitant pathologies: 52 (17.9%) • Cervical spine (CS): 9 (16.3%) • Thoracic spine (TS): 25 (45.4%) • Lumbar spine (LS): 21 (38.1%) 16%
18% 38% 82% Idiopathic S. / MRG
Normal Pathology
46% Intraspinal pathology (%)
CS TS LS
Results • Congenital scoliosis: 48 • Gender: 31 F, 17 M • Age: 15 y (5-35) • Concomitant pathologies: 43 (89.5%) • CS: 15 (34.8%) • TS: 27 (41.5%) • LS: 23 (35.8%)
Congenital Scoliosis
10%
35% Pathology Normal 90% Congenital S./ MRI
23% 42%
Intraspinal pathology
CS TS LS
Results • Neuromuscular scoliosis: 44 • Gender: 30 F, 14 M • Age: 15.3 y (4-30) • Concomitant pathologies: 30 (68.1%) • CS: 15 (31.9%) • TS: 15 (31.9%)
CP + Syringohydromyelia
• LS: 17 (36.1%)
32%
36%
32% 68% Neuromuscular S. / MRI
Pathology Normal
Myelomeningocel (Spina Bifida)
32% Intraspinal pathology
CS TS LS
Results • Syndromic scoliosis : 20 • Gender: 6 F, 14 M • Age: 14 y (10-18) • Concomitant pathologies: 12 (60%) • CS: 5 (41.6%) • TS: 7 (58.3%) • LS: (-) Escobar
42%
Pathology
40%
Jarcho-Levin Syndrome
58% 60%
Syndromic scoliosis / MRI
Normal Intraspinal pathology
CS TS
Results • Total of 179 pathologies (137 patients) were diagnosed. • Most effected areas: • TS: 41,3% (74) • LS: 34% (61) • CS: 24.5% (44)
TS
LS
CS
74 61 44
TS
LS
CS
Results • Most common pathologies: • Syringomyelia: 37.4% (67 cases) • CS: 22, TS: 36, LS: 9 (p>0.05)
• Congenital vertebral anomalies: 22.3% (40)
CP + Syringohydromyelia
• CS: 8, TS: 22, LS: 10 (p>0.05)
Syringohidromyelia + Cranioservical pathology
• Spondilolisthesis: 7.2% (13) • CS: 1, TS: 0, LS: 6 (p=0.002)
• Diastematomyelia (split cord): 5.5% (10) • CS: 2, TS: 4, LS: 4 (p>0.05)
• Tethered cord: 5.5% (10) • CS: 0, TS: 0, LS: 10 (p>0.05)
• Schmorl nod: 4.4% (8)
Hemivertebra
Neuroenteric Cyst + Syringomyelia + Hemivertebra
• CS: 0, TS: 5, LS: 3 (p>0.05)
• Dural echtasia: 2.2% (4) • CS: 0, TS: 0, LS: 4 (p=0.019) Spondilolisthesis
Tethered Cord + Diastometamyelia
Conclusion • Pathologies vary according to scoliosis type. • MRI is crucial in detecting these pathologies. • In our study the average rate of spinal pathologies in scoliotic patients was 34%. • • • •
IS 17.9% SS 60% NS 68.1% CS 89.5%
Most common pathologies
Diagnosis
%
Number CS
TS
LS
(p)
Syringomyelia
37.4
67
22
36
9
p>0.05
Congenital Vertebral Anomalies
22.3
40
8
22
10
p>0.05
Spondylolisthesis
7.2
13
1
-
1
p=0.002
Diastematomyelia
5.5
10
2
4
4
p>0.05
Tethered spinal cord
5.5
10
-
-
10
p>0.05
Schmorl
4.4
8
-
5
3
p>0.05
Dural Ectasia
2.2
4
-
-
4
p=0.019
Cerebellar tonsillar hernia
1.6
3
-
-
3
p=0.009
C1/C2 cervical pathologia
1.6
3
3
-
-
p=0.009
Conclusion • The most common pathology was syringomyelia and the most commonly effected spinal area was Thorasic spine. • The rate of spinal pathologies in Congenital scoliosis were the highest among all scolitic deformities.
