MRI OF IDIOPATHIC JUVENILE SCOLIOSIS - A PROSPECTIVE-STUDY

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 y ears. In eight patients (26%) there was a significant neuroanatomical abnormality; there were six cases of Chiari-l malformation associated with a syrinx, one isolated Chiari-l malformation and one astrocytoma of the cervical spine. Four of these patients had left-sided curves. T here were no clinical features which could reliably identify those pat ients with abnormalities on MRT. In particular, the unilateral absence of abdominal reflexes was found to be non-specific (1 of 8 of patient s with neuroanatomical abnormalities (12.5%) v 2 of 23 with normal sca ns (8.7%)). In view of the established risks of surgical correction of scoliosis in the presence of undecompressed syringomyelia and the pos sible improvement that may follow decompression of the foramen magnum, we feel that MRI of all patients with scoliosis of juvenile onset sho uld be obligatory.