Spine
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Multicenter Study
Use and outcome of MRI in the surgical treatment of adolescent idiopathic scoliosis.
Multicenter, prospective, consecutive clinical series. OBJECTIVE.: To report on the use and outcomes of preoperative magnetic resonance imaging (MRI) in a prospective cohort study of 2206 children undergoing posterior spinal fusion and instrumentation for adolescent idiopathic scoliosis. ⋯ Use of preoperative MRI was 41.8%; 9.9% of patients with so-called "idiopathic" scoliosis had an abnormality on MRI, of which 4.2% were neural anomalies. Of these, syrinx was 66.7%, Chiari was 30.7%, and tethered cord was 2.6%. Significant risk factors for neural abnormality were thoracic hyperkyphosis and juvenile onset. Other characteristics, including apex left thoracic curve, Risser less than or equal to 1, large curve magnitude, triple major curve, male sex, and obesity were not associated with neural abnormality. There were no differences in complication rates between normal and abnormal MRI patients. Our data question the routine use of MRI as a screening tool for adolescent idiopathic scoliosis.