Abstract
ObjectiveThis is the first systematic review and meta-analysis on the overall incidence of intraspinal abnormalities in patients with congenital scoliosis (CS) and potential influencing factors.MethodsWe searched three large electronic databases (PubMed, EMBASE, and Cochrane Library) for potentially relevant studies. The quality of the included studies was assessed independently by two authors using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Data on the number of CS patients, number of CS patients with intraspinal abnormalities, sex of the patients, and CS types were extracted from the included studies. R software was used to pool and analyze all the extracted data.ResultsThis meta-analysis included 10 articles, and 671 of 1863 CS patients undergoing magnetic resonance imaging (MRI) examinations were identified to have intraspinal abnormalities. The overall incidence of intraspinal abnormalities in the patients with CS was 37% (95% CI, 29–45%). Diastematomyelia was the most common intraspinal abnormality and was detected in 45.60% of the patients with intraspinal abnormalities (306/671). The remaining intraspinal abnormalities included syringomyelia (273/671, 40.69%), tethered cord (190/671, 28.32%), low conus (58/671, 8.64%), intraspinal mass (39/671, 5.81%), Chiari malformation (32/671, 4.77%), fatty filum (27/671, 4.02%), spina bifida (occulta excluded) (17/671, 2.53%), tumor (17/671, 2.53%), cyst (12/671, 1.79%), syringomyelus (4/671, 0.60%), dural ectasia (1/671, 0.15%), and undiagnosed cord MRI hyperintensity (1/671, 0.15%). The patient’s sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients (all P > 0.05).ConclusionsThis meta-analysis revealed that the overall incidence of intraspinal abnormalities detected by MRI in CS patients was 37%. Diastematomyelia was the most common intraspinal abnormality. The patient’s sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients.
Highlights
Congenital scoliosis (CS) is a curvature of the spine resulting from abnormal vertebral development during 4 to 6 weeks of gestation [1, 2]
The exclusion criteria were as follows: (1) no specific intraspinal abnormalities were reported; (2) duplicate data were reported by the same author in the same institution; (3) the article was not published in English; (4) the articles were conference abstracts, animal trials, or a case report; and (5) the patients had metabolic diseases, adolescent idiopathic scoliosis, degenerative scoliosis, simple kyphosis, mixed deformity, or scoliosis secondary to infection or tuberculosis
The intraspinal abnormalities observed in our study included diastematomyelia (45.60%), syringomyelia (40.69%), tethered cord (28.32%), low conus (8.64%), intraspinal mass (5.81%), Chiari malformation (4.77%), fatty filum (4.02%), spina bifida (2.53%), tumor (2.53%), cyst (1.79%), syringomyelus (0.60%), dural ectasia (0.15%), and undiagnosed cord magnetic resonance imaging (MRI) hyperintensity (0.15%)
Summary
Congenital scoliosis (CS) is a curvature of the spine resulting from abnormal vertebral development during 4 to 6 weeks of gestation [1, 2]. Vertebral anomalies leading to CS are classified according to whether there is failure of formation, failure of segmentation, or mixed abnormalities [6]. CS is often associated with intraspinal abnormalities and defects of other organs [1, 8,9,10,11]. During the surgical correction of scoliosis, the risk of neurological injury considerably increases with the presence of intraspinal abnormalities [7, 12,13,14]. It is necessary to detect intraspinal abnormalities in patients with CS before corrective surgery is performed
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
