Clinical Relevance of Painful Congenital Early-onset Scoliosis: A Magnetic Resonance Image-based Study.

Autor:	Ramirez N; Pediatric Orthopedic Department, Mayagüez Medical Center, Mayagüez., Deliz-Jimenez D; Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico., Torres-Lugo N; Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico., Olivella G; Orthopaedic Surgery Department, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico., Cahill P; Pediatric Orthopedic Department, The Children's Hospital of Philadelphia., Gupta P; Orthopedic Surgery Department, Shriners Hospitals for Children-Chicago, Chicago, IL., Garg S; Orthopedic Surgery Department, Children's Hospital, Aurora, CO., Pahys J; Orthopedic Surgery Department, Shriners Hospitals for Children-Philadelphia, Philadelphia, PA., Mac-Thiong JM; Département de chirurgie, CHU Sainte-Justine, Université de Montréal, Montréal, QC, Canada.
Jazyk:	angličtina
Zdroj:	Journal of pediatric orthopedics [J Pediatr Orthop] 2024 Apr 01; Vol. 44 (4), pp. 232-235. Date of Electronic Publication: 2024 Jan 25.
DOI:	10.1097/BPO.0000000000002622
Abstrakt:	Background: Back pain, as a clinical marker in scoliosis, has been associated with underlying pathology for many years, warranting further magnetic resonance imaging (MRI). Failures of segmentation, mixed defects, female gender, rib anomalies, congenital thoracic anomalies, and neurocutaneous markers are known risk factors for abnormal MRI pathology findings in patients with congenital early-onset scoliosis (Congenital-EOS). Yet, back pain has not been evaluated as a risk factor for underlying MRI pathology in patients with Congenital-EOS. This study aimed to assess back pain as a risk factor for underlying pathology in Congenital-EOS using MRI as a diagnostic tool. Methods: A retrospective database review from the Pediatric Spine Study Group (PSSG) of all patients with Congenital-EOS who reported a back pain complaint, and underwent a spinal MRI study before surgical intervention was performed. Patients were divided into those with an underlying MRI pathology and those without. Demographics were compared between groups. Results: From a total of 2355 patients with Congenital-EOS registered in PSSG, 107 patients reported a back pain complaint, with only 42 patients fulfilling the inclusion criteria (being evaluated with an MRI study). Overall group mean age was 8.1±4.5 years, with 25 of the 42 patients (60%) being females. Twenty-four of 42 patients (57%) had a comorbidity reported such as cardiac problems, musculoskeletal complaints, neurological deficits/myelopathy, gastrointestinal symptoms, developmental delay, respiratory problems, craniofacial abnormalities, and chromosomal conditions. An underlying MRI pathology was found in 21 of 42 patients with Congenital-EOS (50%) with back pain. The underlying MRI pathologies found were tethered spinal cord, spinal canal stenosis, syringomyelia, Arnold-Chiari malformation, and arachnoid cyst. Conclusions: Abnormal MRI findings are common in patients with Congenital-EOS who report back pain. Gender, age, major coronal curve angle, thoracic or lumbar predominance deformity, and comorbidities type or amount were not associated with abnormal MRI findings. Level of Evidence: Level II-Prognostic study. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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