Evaluating congenital spine deformities for intraspinal anomalies with magnetic resonance imaging

The incidence of intraspinal abnormalities associated with congenital spina l anomalies as detected by magnetic resonance imaging (MRI) is becoming bet ter defined. In this study, 41 nonrandomized children with congenital spina l deformities (excluding myelomeningocele) who underwent complete MR evalua tion were reviewed. Of the 41 congenital spinal deformities, 37 demonstrate d congenital scoliosis, with failure of formation in 19, failure of segment ation in 4, and mixed defects in 14. The remaining foul deformities were ca ses of congenital kyphosis. Thirteen patients with congenital spine anomali es were noted to have intraspinal abnormalities identified by MRI: tethered curd in 12 patients, syringomyelia in 3 patients, and diastematomyelia in 5 patients. Of the 12 patients with tethered cord, 2 patients had neurologi c deficits. Urorectal anomaly was one of the most common associated finding s (15%). Considering an incidence of intraspinal anomalies of 31% and as cl inical manifestations may not be initially detectable, MRI is recommended i n patients with congenital spinal deformity as part of the initial evaluati on even in the absence of clinical findings.