Royal National Orthopaedic Hospital NHS Trust, Brockley Hill, Stanmore, Middlesex, UK.
Eur Spine J. 2012 Jun;21(6):1106-10. doi: 10.1007/s00586-012-2175-5. Epub 2012 Feb 4.
The indications for magnetic resonance imaging in presumed adolescent idiopathic scoliosis (AIS) have not been established, with some studies suggesting that rates of spinal cord abnormalities are low and question the use of the routine MRI in AIS.
Given the restraints on MRI resources the authors performed a retrospective audit to see if the presence of coronal or sagittal misbalance-balance could be used as a surrogate marker for the presence of spinal cord abnormalities in this patient group and hence reduce the need for unnecessary MRI scans.
We performed a retrospective review of imaging of patients with AIS at our centre over a 2-year-period. All MRI scans were reported by the senior author and the presence of spinal cord abnormalities noted. All plain films were assessed by a senior SpR and ST2 orthopaedic surgeons for Cobb angle, coronal balance, sagittal balance and Lenke classification.
A total of 171 patients were identified with AIS. Of these, a total of 15 patients (9%) were found to have neural axis anomalies on MRI including syringomyelia, Chiari malformations and dural ectasia. The average Cobb angle was 44.9° with coronal balance varying from 67.2 mm left to 40.2 mm right. Sagittal balance varied from 125 mm negative to 83 mm positive. No correlation was found between coronal/sagittal misbalance and the presence of neural axis anomalies.
Our audit demonstrates that neither coronal nor sagittal misbalance should be used as an indicator of neural axis abnormalities.
在疑似青少年特发性脊柱侧凸（AIS）中，磁共振成像的适应证尚未确定，一些研究表明脊髓异常的发生率较低，质疑在 AIS 中常规使用 MRI。
鉴于 MRI 资源的限制，作者进行了回顾性审计，以了解冠状或矢状失衡-平衡是否可以作为该患者群体中脊髓异常存在的替代标志物，从而减少不必要的 MRI 扫描。
我们对 2 年来在我们中心接受 AIS 治疗的患者的影像学资料进行了回顾性分析。所有 MRI 扫描均由资深作者报告，并记录脊髓异常的存在。所有平片均由资深 SpR 和 ST2 骨科医生评估 Cobb 角、冠状平衡、矢状平衡和 Lenke 分类。
共确定了 171 例 AIS 患者。其中，共有 15 名患者（9%）的 MRI 显示存在神经轴异常，包括脊髓空洞症、Chiari 畸形和硬脑膜扩张症。平均 Cobb 角为 44.9°，冠状平衡从左侧 67.2mm 到右侧 40.2mm 不等。矢状平衡从负 125mm 到正 83mm 不等。冠状/矢状失衡与神经轴异常之间未发现相关性。
我们的审计表明，冠状或矢状失衡都不应该作为神经轴异常的指标。
