Vertebral, intraspinal and other organ anomalies in congenital scoliosis
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ORIGINAL ARTICLE
Vertebral, intraspinal and other organ anomalies in congenital scoliosis S. P. Mohanty1 · Madhava Pai Kanhangad1 · Jayakrishnan K. Narayana Kurup1 · Sibin Saiffudeen1 Received: 12 January 2020 / Revised: 12 March 2020 / Accepted: 2 May 2020 © The Author(s) 2020
Abstract Aims This study was undertaken to describe the pattern of vertebral, intraspinal and other organ anomalies in patients with congenital scoliosis and to determine the correlation between them. Methods Complete medical and radiological records of 227 consecutive patients with congenital scoliosis were analysed. The radiographs were examined for type of vertebral anomaly, location and severity of deformity. The median curve progression index (MCPI) was calculated in 198 patients. The magnetic resonance imaging (MRI) of the whole spine was analysed to detect the presence of cord abnormalities. The presence of other organ-system anomalies was also noted. The independent sample t test was used to compare severity of deformity between those with and without cord anomalies. The Chi-square test was used to compare frequency of cord abnormalities in different vertebral and organ-system anomalies. Results Hemivertebra with contralateral bar had the highest MCPI, while block vertebrae and wedge vertebrae had the lowest MCPI. Forty-eight patients had 83 cord anomalies. There was no statistically significant difference in severity of deformity, between those with and without cord anomalies. Failure of segmentation had the highest frequency of cord anomalies (p = 0.01). There was no significant difference in the frequency of cord anomalies between those with and without other organ defects. Conclusion Curve progression can be predicted by the underlying vertebral abnormalities. However, it cannot predict cord and other organ-system anomalies. Thus, all patients with congenital scoliosis must undergo MRI of the spine, electro- and echocardiography and ultrasonography of the abdomen to detect occult abnormalities and optimize the patient prior to deformity correction. Keywords Congenital scoliosis · Vertebral anomalies · Intraspinal anomalies · Magnetic resonance imaging
Introduction Around 8 weeks of intrauterine life, the bony elements of the spine begin to form and the neuraxis completes its infolding, to form the neural tube [1]. Any event during this period can lead to abnormalities of the spinal column as well as the spinal cord. Abnormalities of the bony elements present as failure of formation, failure of segmentation or both in the form of mixed anomalies. These abnormalities cause an imbalance in the longitudinal growth of the spine resulting in congenital spinal deformity. Multiple fused ribs when * Madhava Pai Kanhangad [email protected]; [email protected] 1
Division of Spine Surgery, Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka 576‑104, India
present with bony bars on the concave side may result in rapid curve progression. Even though the contribut
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