Department of Orthopaedics and Rehabilitation, Dwight D. Eisenhower Army Medical Center, Fort Gordon, Georgia, United States.
Global Spine J. 2014 Dec;4(4):223-8. doi: 10.1055/s-0034-1387179. Epub 2014 Aug 5.
Study Design Retrospective case series. Objective To determine the rate of spinal incidental findings on magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine in the pediatric population. Methods We reviewed MRI imaging of the neuraxial spine in patients less than 18 years of age and documented abnormal spinal findings. We then reviewed the charts of these patients to determine the reason for ordering the study. Those who presented with pain were considered symptomatic. Those who had no presenting complaint were considered asymptomatic. The data were analyzed to break down the rate of spinal incidental findings in the cervical, thoracic, and lumbar spine, respectively. Results Thirty-one of the 99 MRIs had positive findings, with the most common being disk protrusion (51.6%). Spinal incidental findings were most common in the lumbar spine (9.4%) versus the cervical spine (8%) or thoracic spine (4.7%). In this group, Schmorl nodes and disk protrusion were the two most common findings (37.5% each). Other spinal incidental findings included a vertebral hemangioma and a Tarlov cyst. In the thoracic spine, the only spinal incidental finding was a central disk protrusion without spinal cord or nerve root compression. Conclusion MRI is a useful modality in the pediatric patient with scoliosis or complaints of pain, but the provider should remain cognizant of the potential for spinal incidental findings.
回顾性病例系列研究。目的:确定儿童人群颈椎、胸椎和腰椎磁共振成像(MRI)的脊柱偶然发现率。方法:我们回顾了年龄小于 18 岁的患者的脊柱神经系统 MRI 影像,并记录了异常的脊柱发现。然后,我们查阅了这些患者的病历,以确定进行研究的原因。有疼痛症状的患者被认为是有症状的。无症状患者是指没有任何不适症状的患者。对数据进行分析,以分别细分颈椎、胸椎和腰椎的脊柱偶然发现率。结果:99 例 MRI 中有 31 例有阳性发现,最常见的是椎间盘突出(51.6%)。脊柱偶然发现最常见于腰椎(9.4%),其次是颈椎(8%)或胸椎(4.7%)。在这一组中,Schmorl 结节和椎间盘突出是最常见的两种发现(各占 37.5%)。其他脊柱偶然发现包括椎体血管瘤和 Tarlov 囊肿。在胸椎中,唯一的脊柱偶然发现是中央椎间盘突出,没有脊髓或神经根受压。结论:MRI 是脊柱侧凸或有疼痛症状的儿科患者的有用检查方法,但临床医生应注意脊柱偶然发现的可能性。