MRI Complete Spine Congenital scoliosis as a result of abnormal vertebral formation and segmentation has been shown to be associated with a high incidence of intraspinal anomalies, with a reported prevalence ranging from 20% to 58% [11]. Underlying anomalies include tethered cord, filar lipoma, syringohydromyelia, and diastematomyelia [11]. In a study of 76 patients, Belmont et al [11] noted a prevalence of intraspinal anomalies in 28% of patients with isolated hemivertebra and 21% of patients with more complex vertebral anomalies. Interestingly, history and physical examination only demonstrated an accuracy of 62% for diagnosing an intraspinal anomaly with a hemivertebra. Shen et al [24], in a study of 226 Chinese surgical cases for congenital scoliosis, found a 43% incidence of intraspinal anomalies, the most common being diastematomyelia. Again, similar to the study by Belmont et al, a negative neurologic examination did not predict a normal MRI examination. MRI was suggested in both of these studies for the complete evaluation of congenital scoliosis. CT Spine CT may play a role in the initial imaging evaluation of congenital scoliosis. Multiplanar and 3-D volume rendered reformatted images derived from the axially acquired data set provide multiple views of the spine, allowing a perspective not readily available with conventional radiographs [25,26]. CT may specifically aid in the visualization and characterization of the osseous septum in type I split cord malformations [27]. CT is also helpful in presurgical planning for congenital scoliosis, facilitating visualization of the bony malformations and reducing instrumentation-related complications. Wu et al [26] reported a reduction in the rate of screw misplacement using CT-assisted planning, 6.5% as compared to 15.3% when using C-arm alone. Bone Scan Complete Spine Tc-99m MDP is not a primary imaging modality in the setting of congenital scoliosis as it provides no intraspinal information. Variant 2: Child (0 to 9 years of age).
Scoliosis Child. MRI Complete Spine Congenital scoliosis as a result of abnormal vertebral formation and segmentation has been shown to be associated with a high incidence of intraspinal anomalies, with a reported prevalence ranging from 20% to 58% [11]. Underlying anomalies include tethered cord, filar lipoma, syringohydromyelia, and diastematomyelia [11]. In a study of 76 patients, Belmont et al [11] noted a prevalence of intraspinal anomalies in 28% of patients with isolated hemivertebra and 21% of patients with more complex vertebral anomalies. Interestingly, history and physical examination only demonstrated an accuracy of 62% for diagnosing an intraspinal anomaly with a hemivertebra. Shen et al [24], in a study of 226 Chinese surgical cases for congenital scoliosis, found a 43% incidence of intraspinal anomalies, the most common being diastematomyelia. Again, similar to the study by Belmont et al, a negative neurologic examination did not predict a normal MRI examination. MRI was suggested in both of these studies for the complete evaluation of congenital scoliosis. CT Spine CT may play a role in the initial imaging evaluation of congenital scoliosis. Multiplanar and 3-D volume rendered reformatted images derived from the axially acquired data set provide multiple views of the spine, allowing a perspective not readily available with conventional radiographs [25,26]. CT may specifically aid in the visualization and characterization of the osseous septum in type I split cord malformations [27]. CT is also helpful in presurgical planning for congenital scoliosis, facilitating visualization of the bony malformations and reducing instrumentation-related complications. Wu et al [26] reported a reduction in the rate of screw misplacement using CT-assisted planning, 6.5% as compared to 15.3% when using C-arm alone. Bone Scan Complete Spine Tc-99m MDP is not a primary imaging modality in the setting of congenital scoliosis as it provides no intraspinal information. Variant 2: Child (0 to 9 years of age).