Clinical relevance of preoperative MRI in adolescent idiopathic scoliosis: Is hydromyelia a predictive factor of intraoperative electrophysiological monitoring alterations?

Laura Scaramuzzo, Fabrizio Giudici, Marino Archetti, Leone Minoia, Antonino Zagra, Daniele Bongetta

Research output: Contribution to journalArticle

Abstract

Study Design:This was a prospective cohort study.Objectives:The main objectives of this study were to evaluate the prevalence and clinical relevance of neuroaxial anomalies in adolescent idiopathic scoliosis (AIS) patients as well as to evaluate different clinical and radiologic variables as potential predictors of the presence of a magnetic resonance imaging (MRI) abnormality.Summary of Background Data:The usefulness of preoperative magnetic resonance imaging in AIS is still debated in the literature as well as the clinical relevance of the neuroaxial anomalies detected.Materials and Methods:We performed an analysis on 88 patients affected by AIS with normal neurological examination undergoing a posterior arthrodesis intervention. Patients were stratified according to the presence and type of neuroaxial abnormalities and were compared by age, sex, Risser grading, Lenke curve type, coronal and sagittal curve parameters, presence of alterations at intraoperative neuromonitoring, and "pain" and "function" scores at the SRS-22 test.Results:Neuroaxial abnormalities were reported in 23 patients (26.14%): 14 hydromyelias, 7 syringomyelias, 1 case of Chiari I syndrome, and 1 case of spinal ependymoma. Age, sex, Risser grading, curve type, and coronal and sagittal curve parameters did not differ between normal patients and patients with any neuroaxial abnormality. Alterations of motor-evoked potential/somatosensory-evoked potential monitoring during surgery were reported in 23 patients; the difference in their incidence between normal (20%) and hydromyelia (64%) patients was significant (P<0.01). In evaluating the subareas of the SRS-22 test, we found that the "function" scores differed significantly by comparing normal (21.5±1.6) and hydromyelia (20.4±1.8) patients (P<0.05).Conclusions:The prevalence of neuroaxial abnormalities in AIS patients is relatively high, but we could not identify any definitive clinical or radiologic predictor of their presence. Hydromyelia was correlated with intraoperative motor-evoked potential/somatosensory-evoked potential electrophysiological alterations.

Original languageEnglish
Pages (from-to)E183-E187
JournalClinical Spine Surgery
Volume32
Issue number4
DOIs
Publication statusPublished - May 1 2019

Fingerprint

Intraoperative Monitoring
Scoliosis
Magnetic Resonance Imaging
Motor Evoked Potentials
Somatosensory Evoked Potentials
Ependymoma
Arthrodesis
Neurologic Examination
Cohort Studies
Prospective Studies

Keywords

  • AIS
  • electrophysiological monitoring
  • hydromyelia
  • MEP
  • MRI
  • neuroaxial abnormalities
  • patent central canal
  • SSEP
  • syringomyelia

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Clinical relevance of preoperative MRI in adolescent idiopathic scoliosis : Is hydromyelia a predictive factor of intraoperative electrophysiological monitoring alterations? / Scaramuzzo, Laura; Giudici, Fabrizio; Archetti, Marino; Minoia, Leone; Zagra, Antonino; Bongetta, Daniele.

In: Clinical Spine Surgery, Vol. 32, No. 4, 01.05.2019, p. E183-E187.

Research output: Contribution to journalArticle

@article{4892181603874517904a2ea81f9c3adc,
title = "Clinical relevance of preoperative MRI in adolescent idiopathic scoliosis: Is hydromyelia a predictive factor of intraoperative electrophysiological monitoring alterations?",
abstract = "Study Design:This was a prospective cohort study.Objectives:The main objectives of this study were to evaluate the prevalence and clinical relevance of neuroaxial anomalies in adolescent idiopathic scoliosis (AIS) patients as well as to evaluate different clinical and radiologic variables as potential predictors of the presence of a magnetic resonance imaging (MRI) abnormality.Summary of Background Data:The usefulness of preoperative magnetic resonance imaging in AIS is still debated in the literature as well as the clinical relevance of the neuroaxial anomalies detected.Materials and Methods:We performed an analysis on 88 patients affected by AIS with normal neurological examination undergoing a posterior arthrodesis intervention. Patients were stratified according to the presence and type of neuroaxial abnormalities and were compared by age, sex, Risser grading, Lenke curve type, coronal and sagittal curve parameters, presence of alterations at intraoperative neuromonitoring, and {"}pain{"} and {"}function{"} scores at the SRS-22 test.Results:Neuroaxial abnormalities were reported in 23 patients (26.14{\%}): 14 hydromyelias, 7 syringomyelias, 1 case of Chiari I syndrome, and 1 case of spinal ependymoma. Age, sex, Risser grading, curve type, and coronal and sagittal curve parameters did not differ between normal patients and patients with any neuroaxial abnormality. Alterations of motor-evoked potential/somatosensory-evoked potential monitoring during surgery were reported in 23 patients; the difference in their incidence between normal (20{\%}) and hydromyelia (64{\%}) patients was significant (P<0.01). In evaluating the subareas of the SRS-22 test, we found that the {"}function{"} scores differed significantly by comparing normal (21.5±1.6) and hydromyelia (20.4±1.8) patients (P<0.05).Conclusions:The prevalence of neuroaxial abnormalities in AIS patients is relatively high, but we could not identify any definitive clinical or radiologic predictor of their presence. Hydromyelia was correlated with intraoperative motor-evoked potential/somatosensory-evoked potential electrophysiological alterations.",
keywords = "AIS, electrophysiological monitoring, hydromyelia, MEP, MRI, neuroaxial abnormalities, patent central canal, SSEP, syringomyelia",
author = "Laura Scaramuzzo and Fabrizio Giudici and Marino Archetti and Leone Minoia and Antonino Zagra and Daniele Bongetta",
year = "2019",
month = "5",
day = "1",
doi = "10.1097/BSD.0000000000000820",
language = "English",
volume = "32",
pages = "E183--E187",
journal = "Clinical Spine Surgery",
issn = "2380-0186",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Clinical relevance of preoperative MRI in adolescent idiopathic scoliosis

T2 - Is hydromyelia a predictive factor of intraoperative electrophysiological monitoring alterations?

AU - Scaramuzzo, Laura

AU - Giudici, Fabrizio

AU - Archetti, Marino

AU - Minoia, Leone

AU - Zagra, Antonino

AU - Bongetta, Daniele

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Study Design:This was a prospective cohort study.Objectives:The main objectives of this study were to evaluate the prevalence and clinical relevance of neuroaxial anomalies in adolescent idiopathic scoliosis (AIS) patients as well as to evaluate different clinical and radiologic variables as potential predictors of the presence of a magnetic resonance imaging (MRI) abnormality.Summary of Background Data:The usefulness of preoperative magnetic resonance imaging in AIS is still debated in the literature as well as the clinical relevance of the neuroaxial anomalies detected.Materials and Methods:We performed an analysis on 88 patients affected by AIS with normal neurological examination undergoing a posterior arthrodesis intervention. Patients were stratified according to the presence and type of neuroaxial abnormalities and were compared by age, sex, Risser grading, Lenke curve type, coronal and sagittal curve parameters, presence of alterations at intraoperative neuromonitoring, and "pain" and "function" scores at the SRS-22 test.Results:Neuroaxial abnormalities were reported in 23 patients (26.14%): 14 hydromyelias, 7 syringomyelias, 1 case of Chiari I syndrome, and 1 case of spinal ependymoma. Age, sex, Risser grading, curve type, and coronal and sagittal curve parameters did not differ between normal patients and patients with any neuroaxial abnormality. Alterations of motor-evoked potential/somatosensory-evoked potential monitoring during surgery were reported in 23 patients; the difference in their incidence between normal (20%) and hydromyelia (64%) patients was significant (P<0.01). In evaluating the subareas of the SRS-22 test, we found that the "function" scores differed significantly by comparing normal (21.5±1.6) and hydromyelia (20.4±1.8) patients (P<0.05).Conclusions:The prevalence of neuroaxial abnormalities in AIS patients is relatively high, but we could not identify any definitive clinical or radiologic predictor of their presence. Hydromyelia was correlated with intraoperative motor-evoked potential/somatosensory-evoked potential electrophysiological alterations.

AB - Study Design:This was a prospective cohort study.Objectives:The main objectives of this study were to evaluate the prevalence and clinical relevance of neuroaxial anomalies in adolescent idiopathic scoliosis (AIS) patients as well as to evaluate different clinical and radiologic variables as potential predictors of the presence of a magnetic resonance imaging (MRI) abnormality.Summary of Background Data:The usefulness of preoperative magnetic resonance imaging in AIS is still debated in the literature as well as the clinical relevance of the neuroaxial anomalies detected.Materials and Methods:We performed an analysis on 88 patients affected by AIS with normal neurological examination undergoing a posterior arthrodesis intervention. Patients were stratified according to the presence and type of neuroaxial abnormalities and were compared by age, sex, Risser grading, Lenke curve type, coronal and sagittal curve parameters, presence of alterations at intraoperative neuromonitoring, and "pain" and "function" scores at the SRS-22 test.Results:Neuroaxial abnormalities were reported in 23 patients (26.14%): 14 hydromyelias, 7 syringomyelias, 1 case of Chiari I syndrome, and 1 case of spinal ependymoma. Age, sex, Risser grading, curve type, and coronal and sagittal curve parameters did not differ between normal patients and patients with any neuroaxial abnormality. Alterations of motor-evoked potential/somatosensory-evoked potential monitoring during surgery were reported in 23 patients; the difference in their incidence between normal (20%) and hydromyelia (64%) patients was significant (P<0.01). In evaluating the subareas of the SRS-22 test, we found that the "function" scores differed significantly by comparing normal (21.5±1.6) and hydromyelia (20.4±1.8) patients (P<0.05).Conclusions:The prevalence of neuroaxial abnormalities in AIS patients is relatively high, but we could not identify any definitive clinical or radiologic predictor of their presence. Hydromyelia was correlated with intraoperative motor-evoked potential/somatosensory-evoked potential electrophysiological alterations.

KW - AIS

KW - electrophysiological monitoring

KW - hydromyelia

KW - MEP

KW - MRI

KW - neuroaxial abnormalities

KW - patent central canal

KW - SSEP

KW - syringomyelia

UR - http://www.scopus.com/inward/record.url?scp=85065511806&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85065511806&partnerID=8YFLogxK

U2 - 10.1097/BSD.0000000000000820

DO - 10.1097/BSD.0000000000000820

M3 - Article

C2 - 30913042

AN - SCOPUS:85065511806

VL - 32

SP - E183-E187

JO - Clinical Spine Surgery

JF - Clinical Spine Surgery

SN - 2380-0186

IS - 4

ER -