INCIDENCE OF NEURAL AXIS ABNORMALITIES IN INFANTILE AND JUVENILE PATIENTS WITH SPINAL DEFORMITY - IS A MAGNETIC-RESONANCE IMAGE SCREENING NECESSARY

Study Design. A prospective and retrospective review of patients 10 ye ars and younger with idiopathic scoliosis evaluated with a total spine magnetic resonance imaging (MRI) scan. Objectives. To determine the i ncidence of neural axis abnormalities in infantile and juvenile patien ts with idiopathic scoliosis without neurologic findings on history an d examination, to determine the need for a screening MRI in this age g roup. Summary of Background Data. In previous studies, a 19.2% and 26% incidence of neural axis abnormalities were found in infantile and ju venile patients with ''idiopathic'' scoliosis, respectively, raising t he question of routine MRI screening of the spinal canal in these pati ents. Methods. A prospective study included 34 consecutive patients ne wborn to 10 years of age treated between 1992 and 1996 at a spinal def ormity clinic with idiopathic scoliosis >20 degrees without neurologic findings. In addition, a retrospective review of 64 patients age newb orn to 10 years of age with idiopathic scoliosis was performed. All pa tients were evaluated by a total spine MRI protocol for examination of neural axis abnormalities. Results. The incidence of neural axis abno rmalities in the prospective group of 34 patients was 17.6% (6 of 34); the incidence of neural axis abnormalities was 20.3% (13 of 64) in th e retrospective group. Of 6 patients in the infantile age range, 3 (50 %) had neural axis abnormalities. Conclusions. A total spine MRI is re commended at presentation in patients with juvenile onset idiopathic s coliosis (> 20 degrees) because of the high incidence of neural axis a bnormalities. Further study appears warranted to establish the inciden ce of neural axis abnormalities in infantile idiopathic scoliosis to d etermine the need for total spine MRI screening in this age group.