Evans S C, Edgar M A, Hall-Craggs M A, Powell M P, Taylor B A, Noordeen H H
The Middlesex Hospital, London, England.
J Bone Joint Surg Br. 1996 Mar;78(2):314-7.
In a prospective trial we performed MRI of the spine and hind brain in 31 patients with scoliosis of onset between the ages of four and 12 years. In eight patients (26%) there was a significant neuroanatomical abnormality; there were six cases of Chiari-1 malformation associated with a syrinx, one isolated Chiari-1 malformation and one astrocytoma of the cervical spine. Four of these patients had left-sided curves. There were no clinical features which could reliably identify those patients with abnormalities on MRI. In particular, the unilateral absence of abdominal reflexes was found to be non-specific (1 of 8 of patients with neuroanatomical abnormalities (12.5%) v 2 of 23 with normal scans (8.7%). In view of the established risks of surgical correction of scoliosis in the presence of undecompressed syringomyelia and the possible improvement that may follow decompression of the foramen magnum, we feel that MRI of all patients with scoliosis of juvenile onset should be obligatory.
在一项前瞻性试验中，我们对31例4至12岁发病的脊柱侧弯患者进行了脊柱和后脑的磁共振成像（MRI）检查。8例患者（26%）存在明显的神经解剖学异常；其中6例为伴有脊髓空洞症的Chiari-1畸形，1例孤立性Chiari-1畸形，1例颈椎星形细胞瘤。这些患者中有4例为左侧弯曲。没有临床特征能够可靠地识别出MRI检查有异常的患者。特别是，发现单侧腹壁反射消失并无特异性（神经解剖学异常患者中8例有1例（12.5%），扫描正常的23例中有2例（8.7%））。鉴于在存在未减压脊髓空洞症的情况下进行脊柱侧弯手术矫正的既定风险，以及枕骨大孔减压后可能出现的改善情况，我们认为对所有青少年发病的脊柱侧弯患者进行MRI检查应成为常规。
