Spectrum of Intraspinal Anomalies Detected by MRI in Congenital Scoliosis: A 10-Year Single-Center Experience from Pakistan
DOI:
https://doi.org/10.52206/jsmc.2025.15.4.1216Abstract
Background: Congenital scoliosis (CS) results from vertebral malformations and is often associated with intraspinal anomalies such as syringomyelia, diastematomyelia, and Chiari malformation. MRI is the gold standard for their detection, yet regional data from Pakistan are limited.
Objective: To determine the spectrum and frequency of intraspinal anomalies detected by MRI in patients with congenital scoliosis managed at a tertiary care center over a 10-year period.
Methodology: A retrospective observational study was conducted at the Department of Spine and Orthopedic Surgery, Hayatabad Medical Complex, Peshawar, from January 2013 to December 2023. A total of 122 patients with congenital scoliosis who underwent MRI were included. Data regarding demographics, scoliosis curve characteristics, Cobb’s angle, and MRI findings were retrieved from medical records. Intraspinal anomalies such as syringomyelia, diastematomyelia, tethered cord, and Arnold Chiari malformation were identified. Statistical analyses included descriptive measures and multivariate logistic regression to explore associations between scoliosis severity and anomaly type, with significance set at p<0.05.
Results: The mean age of patients was 14.66 ± 7.44 years (range 4–54), with a slight female predominance (54.9%). Right-sided curves were more common (87.7%). Cobb’s angle ranged from 30° to 110°, with a mean of 65.43° ± 14.78. MRI detected intraspinal anomalies in 20.5% of patients: syrinx (14.8%), diastematomyelia (4.1%), and Arnold Chiari malformation (0.8%). Severity of scoliosis (higher Cobb’s angle) was significantly associated with syrinx and diastematomyelia. Surgical interventions included Growing Rod Fixation (32.8%), Posterior Vertebral Column Resection (23.8%), and Posterior Instrumented Spine Fusion (19.7%), with favorable postoperative neurological outcomes in the majority of patients with anomalies.
Conclusion: One-fifth of CS patients had intraspinal anomalies, most commonly syrinx. Routine MRI is crucial for early detection and safe surgical planning.
Keywords: Congenital scoliosis, Intraspinal anomalies, MRI, spinal dysraphism, Syringomyelia.
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