1.Association of Cobb angle progression and neuraxial abnormality on MRI in asymptomatic Adolescent Idiopathic Scoliosis
Faizah Mohd Zaki ; Ng Kai Ling ; Te Boon Chin ; Mohd Hafizuddin Azman ; Nur Aifaa Liah ; Nurhanisah Mohd Razali ; Azmi Baharudin ; Hamzaini Abdul Hamid
The Medical Journal of Malaysia 2016;71(3):122-125
Background: Detection of neuraxial abnormality in
neurologically asymptomatic adolescent idiopathic
scoliosis (AIS) is crucial prior to surgery. It can only be
detected on magnetic resonance imaging (MRI), which was
not routinely done in this group of patient. On the other
hand, whole spine radiographs for measurement of Cobb
angle have been routinely included during clinic follow-up.
This study aimed to determine the correlation between Cobb
angle progression and neuraxial abnormality finding on MRI
in asymptomatic AIS.
Methods: A retrospective study was conducted in the
Orthopaedic department of a tertiary hospital. Patients with
asymptomatic AIS aged 10-20 years who attended scoliosis
clinic from year 2007 to 2010 was reviewed. Patients who
had whole spine MRI and two vertebral radiographs at least
one year apart were further selected. Statistical analysis was
done to see the association between Cobb angle
progression and neuraxial abnormality on MRI.
Results: The mean age at first presentation was 14.4 years
old. Female (n=249) to male (n=50) ratio was 5:1. Only 19
patients fulfilled the selection criteria. There were 5 patients
(26.3%) who had neuraxial abnormalities. The mean curve
progression was 7.05° (range from -5° to 28°). Patients with
and without neuroaxial abnormality showed mean curve
progression of 0.6º and 9.36° respectively. There was no
significant association between Cobb angle progression
and neuroaxial abnormality (p=1.000).
Conclusion: Cobb angle progression is not a reliable
indicator for predicting neuroaxial abnormality in patients
with asymptomatic AIS. However, this study stressed the
need to perform MRI prior to operation to document any
associated neuraxial abnormality in clinically asymptomatic
AIS patients.