EVALUATION OF SPINAL AND OTHER SYSTEM PATHOLOGIES IN EARLY ONSET SCOLIOSIS PATIENTS
Journal Title: Journal of Turkish Spinal Surgery - Year 2013, Vol 24, Issue 3
Abstract
Aim and Purpose: It is very difficult to manage the treatment of early onset scoliosis (EOS). It is necessary to diagnose and start the treatment of patients with EOS as early as possible, and to plan the treatment well. We investigated the pathologies seen in spinal, orthopedic, cardiovascular and other organ systems caused by different etiologies in EOS with the help of magnetic resonance imaging (MRI) and other diagnostic methods, based on etiological reasons. Materials and Methods: We evaluated 62 EOS patients (26 congenital, 21 neuromuscular, 10 syndromic and 5 idiopathic) who received spinal MRIs, and who were operated on and/or managed due to scoliosis between the years of 2005–2011. The mean age at MRI evaluation was 4.3 years of age (3 months–11 years 10 months), and 38 patients were female and 24 were male. For all patients, we investigated the intraspinal, extraspinal and additional organ anomalies with MRI. We measured the coronal and sagittal plane deformity of the spine with the Cobb method. We also investigated the orthopedic pathologies clinically and radiologically, and the additional organ anomalies with abdominal ultrasound and echocardiogram. Results: We found intraspinal anomalies in 48 patients (77.4%), extraspinal anomalies in 46 patients (74.1%), and additional organ anomalies in nine patients (14.5%). We documented 98 intraspinal and 101 extraspinal pathologies with MRI. When evaluated according to the spinal regions, 50 (80.6%) of the patients had pathologies in thoracic, 38 (61%) had lumbar, 28 (45%) cervical, and four (6.4%) had pathologies in sacral areas. The most common intraspinal anomaly, observed at a rate of 54.8% (34 patients), was syringomyelia. Intraspinal anomalies were most common in neuromuscular scoliosis patients, at a rate of 55.1% (54 pathologies). The most frequent extraspinal anomaly was hemivertebrae, seen in 38.7% of patients (24 patients). Extraspinal anomalies were most commonly observed in congenital scoliosis patients, at a rate of 62.37% (63 pathologies). The mean Cobb angle in all cases was measured as 46.6° (10–113°). We found increased kyphosis in 18 (29%) cases and lordosis in four (6.4%) cases. In 37 (59.6%) of the patients, an additional 56 orthopedic pathologies were found. The most commonly co-observed problems were motor weakness in the lower extremities in 12 patients (21%), hip dysplasia in nine (16%) patients, and thorax deformities in nine (16%) patients. Orthopedic pathologies were most commonly observed in neuromuscular scoliosis patients, at a rate of 32% (19 patients). We found cardiovascular anomalies in seven patients (11.2%) (most commonly ASD), urogenital anomalies in 11 patients (17.74%) (most frequently bowel and bladder incontinence), and other organic defects in 12 patients (19.35%) (most frequently inguinal hernia). 33 (53.2%) patients had previously received surgery. 18 (29%) of them had had neurosurgical operations, 15 (24.1%) were operated on for orthopedic or other organ anomalies, and only in seven (11.2%) cases were VEPTR (4), telescopic rod (1), epiphysiodesis (1) or hemivertebra (1) excision applied. Discussion: Even though scoliosis has different etiologies, many spinal and other organ anomalies tend to accompany EOS. Intraspinal anomalies are frequently observed with NS, with syringomyelia as the most common intraspinal anomaly. Extraspinal anomalies of the spine are most frequently seen with CS, and the most common anomaly is hemivertebrae. The thoracic vertebrae are most affected. Orthopedic pathologies are mostly seen with NS. The most commonly encountered cardiovascular anomaly is ASD, which is seen together with SS. In addition to careful clinical and radiological investigations, early MRI investigation can lead to better understanding of accompanying anomalies.
Authors and Affiliations
Mehmet Bülent BALİOĞLU, Yunus ATICI, Akif ALBAYRAK, Seçil Sezgin SAKIZLIOĞLU, Deniz KARGIN, Mehmet Temel TACAL, Mehmet Akif KAYGUSUZ
Keywords
Related Articles
- EP ID EP676765
- DOI -
- Views 132
- Downloads 0
REDUCTION AND STABILIZATION OF SPONDYLOLISTHESIS USING ALICI SPINAL INSTRUMENTATION
In this study, the preliminary results of the surgical treatment of spondylolisthesis using Alia Instrumentation that we have started to use in the recent year in the Orthopaedics and Travmatology Clinics of Dokuz Eylill...
PERCUTANEOUS POSTERIOR FIXATION FOR DEGENERATIVE SPINE PROBLEMS
Minimally invasive approaches to degenerative spine conditions have begun to be used more frequently in the last ten years, in order to minimize the disadvantages related to the traditional approach. There are a couple o...
TWO STAGE RESECTION OF HEMIVERTEBRAE FOR THE TREATMENT OF CONGENITAL LUMBAR SCOLIOSIS
Hemivertebrae, being one ofthe leading causes of congenital scoliosis following unilateral unsegmented bars, may change in number, localization and type. Especially fully segmented ones with lumbosacral localizations lea...
FAILED BACK SURGERY SYNDROME
Failed back surgery syndrome is named for the patients who had been operated once or more for back surgery and not had a success for improvement of back or radicular leg pain. The spine surgeons are frequently faced with...
TREATMENT OF L5-S1 SPONDYLOPTOSIS: CASE REPORT
Spondyloptosis or grade 5 spondylolisthesis is defined as the forward slippage of the entire L5 vertebral body of S1. Reduction of severe spondylolisthesis continues to be a subject of debate; most authors agree that fus...