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In congenital early-onset scoliosis (C-EOS), 20% of patients have neural axis abnormalities. Delaying MRI past age 3 is safe for those with normal exams and imaging, showing no increased complications.

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Area of Science:

  • Pediatric Orthopedics
  • Pediatric Neurosurgery
  • Radiology

Background:

  • Congenital early-onset scoliosis (C-EOS) often requires spinal imaging.
  • Neural axis abnormalities are a concern in C-EOS patients.
  • MRI timing is debated due to potential anesthesia risks in young children.

Purpose of the Study:

  • To determine the prevalence of neural axis abnormalities in C-EOS patients.
  • To assess the correlation between age at MRI and abnormality detection.
  • To evaluate if delaying MRI affects treatment outcomes and complications.

Main Methods:

  • Retrospective review of 659 C-EOS patients from a multicenter registry.
  • Stratification into two groups: MRI before or after age 3.
  • Statistical analysis including Spearman Rho, t-tests, and chi-squared tests.

Main Results:

  • 20% of C-EOS patients had abnormal intraspinal MRI findings.
  • No significant correlation found between age at MRI and abnormal findings (P=0.64).
  • No significant differences in neurosurgical interventions, complications, or unplanned returns to surgery between age groups.

Conclusions:

  • Neural axis abnormalities are present in 20% of C-EOS cases.
  • Age at first MRI does not correlate with the likelihood of abnormalities.
  • MRI may be cautiously deferred in C-EOS patients with normal neurological and radiological findings.