MRI Screening in Operative Scheuermann Kyphosis

Is it Necessary?

Baron S. Lonner, Courtney S. Toombs, Michael Mechlin, Gina Ciavarra, Suken A. Shah, Amer F. Samdani, Paul David Sponseller, Harry L. Shufflebarger, Randal R. Betz, Burt Yaszay, Peter O. Newton

Research output: Contribution to journalArticle

Abstract

Study Design Patients with preoperative spine magnetic resonance imaging (MRI) studies from a prospective multicenter study of operative adolescent Scheuermann kyphosis (SK). Objectives To investigate the usefulness of MRI screening in operative planning for SK surgeries. Summary of Background Data Neural axis abnormalities in operative SK have not been previously studied with MRI screening, despite its use. Methods One orthopedic surgeon and two radiologists evaluated all images retrospectively. Radiographs were evaluated for kyphosis apex and magnitude. MRIs were evaluated for spinal cord abnormalities, epidural lipomatosis, location and number of vertebral wedging, Schmorl nodes and posterior disc herniations, frequency of spondylolysis, etc. The relationship of these pathologies to the kyphosis apex was explored. This group was compared to a surgical SK group without preoperative MRIs. Results Eighty-six patients with MRIs, mean age 16.3 years, 64% male, and a mean preoperative kyphosis of 75.9° were evaluated. There were 17 spinal cord abnormalities. Low-lying conus was found in 2 patients, and syrinx in 15 (no Chiari malformations). Epidural lipomatosis was found in 49 patients, average of 5.7 levels. Anterior vertebral wedging occurred in all (mean 4.7 levels). Posterior disc herniations averaged 5.2 levels/patient and 1.8 levels caudad to the apex. Spondylolysis was reported in 8.1%. Four cases (4.7%) had the operative plan changed as a result of the preoperative MRI: two due to neural compression, one due to disc herniation and one due to a spinal cord draped over the apex. Thirty-one patients did not receive an MRI; there were no significant differences between the two groups. The rate of postoperative neurologic change was 3.5% in the MRI group and 3.2% in the no-MRI group. Conclusions Based on 4.7% of cases requiring a change in the operative plan as a result of preoperative MRI, the authors recommend considering performing screening MRI in operative SK patients.

Original languageEnglish (US)
Pages (from-to)124-133
Number of pages10
JournalSpine Deformity
Volume5
Issue number2
DOIs
StatePublished - Mar 1 2017

Fingerprint

Scheuermann Disease
Magnetic Resonance Imaging
Kyphosis
Spondylolysis
Lipomatosis
Spinal Cord
Syringes
Nervous System
Multicenter Studies
Spine
Prospective Studies

Keywords

  • MRI
  • Scheuermann kyphosis
  • Spinal fusion

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Lonner, B. S., Toombs, C. S., Mechlin, M., Ciavarra, G., Shah, S. A., Samdani, A. F., ... Newton, P. O. (2017). MRI Screening in Operative Scheuermann Kyphosis: Is it Necessary? Spine Deformity, 5(2), 124-133. https://doi.org/10.1016/j.jspd.2016.10.008

MRI Screening in Operative Scheuermann Kyphosis : Is it Necessary? / Lonner, Baron S.; Toombs, Courtney S.; Mechlin, Michael; Ciavarra, Gina; Shah, Suken A.; Samdani, Amer F.; Sponseller, Paul David; Shufflebarger, Harry L.; Betz, Randal R.; Yaszay, Burt; Newton, Peter O.

In: Spine Deformity, Vol. 5, No. 2, 01.03.2017, p. 124-133.

Research output: Contribution to journalArticle

Lonner, BS, Toombs, CS, Mechlin, M, Ciavarra, G, Shah, SA, Samdani, AF, Sponseller, PD, Shufflebarger, HL, Betz, RR, Yaszay, B & Newton, PO 2017, 'MRI Screening in Operative Scheuermann Kyphosis: Is it Necessary?', Spine Deformity, vol. 5, no. 2, pp. 124-133. https://doi.org/10.1016/j.jspd.2016.10.008
Lonner BS, Toombs CS, Mechlin M, Ciavarra G, Shah SA, Samdani AF et al. MRI Screening in Operative Scheuermann Kyphosis: Is it Necessary? Spine Deformity. 2017 Mar 1;5(2):124-133. https://doi.org/10.1016/j.jspd.2016.10.008
Lonner, Baron S. ; Toombs, Courtney S. ; Mechlin, Michael ; Ciavarra, Gina ; Shah, Suken A. ; Samdani, Amer F. ; Sponseller, Paul David ; Shufflebarger, Harry L. ; Betz, Randal R. ; Yaszay, Burt ; Newton, Peter O. / MRI Screening in Operative Scheuermann Kyphosis : Is it Necessary?. In: Spine Deformity. 2017 ; Vol. 5, No. 2. pp. 124-133.
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abstract = "Study Design Patients with preoperative spine magnetic resonance imaging (MRI) studies from a prospective multicenter study of operative adolescent Scheuermann kyphosis (SK). Objectives To investigate the usefulness of MRI screening in operative planning for SK surgeries. Summary of Background Data Neural axis abnormalities in operative SK have not been previously studied with MRI screening, despite its use. Methods One orthopedic surgeon and two radiologists evaluated all images retrospectively. Radiographs were evaluated for kyphosis apex and magnitude. MRIs were evaluated for spinal cord abnormalities, epidural lipomatosis, location and number of vertebral wedging, Schmorl nodes and posterior disc herniations, frequency of spondylolysis, etc. The relationship of these pathologies to the kyphosis apex was explored. This group was compared to a surgical SK group without preoperative MRIs. Results Eighty-six patients with MRIs, mean age 16.3 years, 64{\%} male, and a mean preoperative kyphosis of 75.9° were evaluated. There were 17 spinal cord abnormalities. Low-lying conus was found in 2 patients, and syrinx in 15 (no Chiari malformations). Epidural lipomatosis was found in 49 patients, average of 5.7 levels. Anterior vertebral wedging occurred in all (mean 4.7 levels). Posterior disc herniations averaged 5.2 levels/patient and 1.8 levels caudad to the apex. Spondylolysis was reported in 8.1{\%}. Four cases (4.7{\%}) had the operative plan changed as a result of the preoperative MRI: two due to neural compression, one due to disc herniation and one due to a spinal cord draped over the apex. Thirty-one patients did not receive an MRI; there were no significant differences between the two groups. The rate of postoperative neurologic change was 3.5{\%} in the MRI group and 3.2{\%} in the no-MRI group. Conclusions Based on 4.7{\%} of cases requiring a change in the operative plan as a result of preoperative MRI, the authors recommend considering performing screening MRI in operative SK patients.",
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AU - Lonner, Baron S.

AU - Toombs, Courtney S.

AU - Mechlin, Michael

AU - Ciavarra, Gina

AU - Shah, Suken A.

AU - Samdani, Amer F.

AU - Sponseller, Paul David

AU - Shufflebarger, Harry L.

AU - Betz, Randal R.

AU - Yaszay, Burt

AU - Newton, Peter O.

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N2 - Study Design Patients with preoperative spine magnetic resonance imaging (MRI) studies from a prospective multicenter study of operative adolescent Scheuermann kyphosis (SK). Objectives To investigate the usefulness of MRI screening in operative planning for SK surgeries. Summary of Background Data Neural axis abnormalities in operative SK have not been previously studied with MRI screening, despite its use. Methods One orthopedic surgeon and two radiologists evaluated all images retrospectively. Radiographs were evaluated for kyphosis apex and magnitude. MRIs were evaluated for spinal cord abnormalities, epidural lipomatosis, location and number of vertebral wedging, Schmorl nodes and posterior disc herniations, frequency of spondylolysis, etc. The relationship of these pathologies to the kyphosis apex was explored. This group was compared to a surgical SK group without preoperative MRIs. Results Eighty-six patients with MRIs, mean age 16.3 years, 64% male, and a mean preoperative kyphosis of 75.9° were evaluated. There were 17 spinal cord abnormalities. Low-lying conus was found in 2 patients, and syrinx in 15 (no Chiari malformations). Epidural lipomatosis was found in 49 patients, average of 5.7 levels. Anterior vertebral wedging occurred in all (mean 4.7 levels). Posterior disc herniations averaged 5.2 levels/patient and 1.8 levels caudad to the apex. Spondylolysis was reported in 8.1%. Four cases (4.7%) had the operative plan changed as a result of the preoperative MRI: two due to neural compression, one due to disc herniation and one due to a spinal cord draped over the apex. Thirty-one patients did not receive an MRI; there were no significant differences between the two groups. The rate of postoperative neurologic change was 3.5% in the MRI group and 3.2% in the no-MRI group. Conclusions Based on 4.7% of cases requiring a change in the operative plan as a result of preoperative MRI, the authors recommend considering performing screening MRI in operative SK patients.

AB - Study Design Patients with preoperative spine magnetic resonance imaging (MRI) studies from a prospective multicenter study of operative adolescent Scheuermann kyphosis (SK). Objectives To investigate the usefulness of MRI screening in operative planning for SK surgeries. Summary of Background Data Neural axis abnormalities in operative SK have not been previously studied with MRI screening, despite its use. Methods One orthopedic surgeon and two radiologists evaluated all images retrospectively. Radiographs were evaluated for kyphosis apex and magnitude. MRIs were evaluated for spinal cord abnormalities, epidural lipomatosis, location and number of vertebral wedging, Schmorl nodes and posterior disc herniations, frequency of spondylolysis, etc. The relationship of these pathologies to the kyphosis apex was explored. This group was compared to a surgical SK group without preoperative MRIs. Results Eighty-six patients with MRIs, mean age 16.3 years, 64% male, and a mean preoperative kyphosis of 75.9° were evaluated. There were 17 spinal cord abnormalities. Low-lying conus was found in 2 patients, and syrinx in 15 (no Chiari malformations). Epidural lipomatosis was found in 49 patients, average of 5.7 levels. Anterior vertebral wedging occurred in all (mean 4.7 levels). Posterior disc herniations averaged 5.2 levels/patient and 1.8 levels caudad to the apex. Spondylolysis was reported in 8.1%. Four cases (4.7%) had the operative plan changed as a result of the preoperative MRI: two due to neural compression, one due to disc herniation and one due to a spinal cord draped over the apex. Thirty-one patients did not receive an MRI; there were no significant differences between the two groups. The rate of postoperative neurologic change was 3.5% in the MRI group and 3.2% in the no-MRI group. Conclusions Based on 4.7% of cases requiring a change in the operative plan as a result of preoperative MRI, the authors recommend considering performing screening MRI in operative SK patients.

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