Waseem Amir Bashir MBChB, Presenter: Nothing to Disclose

Paul O'Donnell MBBCh, FRCR, Abstract Co-Author: Nothing to Disclose

Asif Saifuddin MBBS, Abstract Co-Author: Nothing to Disclose

There is a wide range of reported incidence of spinal cord or brainstem anomalies in the patient with “idiopathic” scoliosis. Although previous literature has illustrated that a left thoracic curve is implicated to be associated with underlying causes in scoliosis, no one has looked at impaired truncal balance and its implicated relationship with abnormalities of the spinal cord and brainstem.

359 patients with idiopathic scoliosis (mean age18) were investigated for the relationship of loss of coronal plane balance and presence of spinal cord pathology using MRI. Analysis was performed clinically and radiologically using plain radiography; coronal balance was based on the standard C7 plumb line intersection with centring of the superior S1 endplate with measurements more than 2cm from this point in either direction taken to represent radiographic coronal imbalance. Cobb angles of the scoliotic curves and lateral shift were measured as usual.

161 patients were found to be in coronal balance; 26% of these individuals had an abnormal MRI scan. 179 patients with coronal imbalance had a normal MRI scan. Only 19 patients with coronal imbalance (9%) showed an abnormal scan. Of the abnormalities detected, 46% were Chiari I malformations, 46% had a syrinx, and 2.5% had a primary cord tumour.

Contrary to common belief, we have shown for the first time with the use of modern imaging, that there is no significant association between a neural axis abnormality on MRI and coronal imbalance in idiopathic scoliotic patients.

We have disproved the belief that impaired truncal balance is implicated with abnormalities of the brainstem & spinal cord. The majority of imbalanced idiopathic scoliotic patients had a normal MRI.

Bashir, W, O'Donnell, P, Saifuddin, A, Evaluation of the Relationship between Spinal Cord Abnormalities and Radiological Coronal Imbalance in Idiopathic Scoliosis Patients Using MRI: A Retrospective Imaging Analysis of 359 Patients.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014812.html