Ashfaq Ahmed
Ghurki Trust Teaching Hospital, Pakistan
Title: Magnetic resonance imaging evaluation of the scoliotic patients before spinal instrumentation and fusion: A prospective study in tertiary care hospital
Biography
Biography: Ashfaq Ahmed
Abstract
Introduction: Magnetic resonance imaging is necessary pre-operatively to assess the prevalence of structural and functional abnormalities within the spinal cord in patients with scoliosis. Th ere is no consensus on the use of MRI in these patients pre-operatively. MRI, echocardiography and ultrasound should be a part of routine evaluation in all these patients before surgery, no matter positive clinical fi ndings were found or not. Objective: Th e main objective of this study was to analyze the occult spinal pathologies associated with diff erent types of scoliosis. Methodology: Th is was a prospective study include 89 patients who was diagnosed as a case of scoliosis and were planned for scoliosis surgery from January 2015 to December 2018 aft er Hospital Ethical Committee approval and written informed consent from the patients. Th e patients who were unfi t for surgery or managed conservatively were excluded from the study. All the patients underwent magnetic resonance imaging preoperatively. Th e MRI fi ndings of these patients were initially recorded on a pre formed pro forma and then analyzed using SPSS 21.0 version. Results: Th ere were 29 (33.37%) males and 58 (66.67%) females with male to female ratio of 0.5:1 and with mean age of 14.54±2.34 years. Th ere were 56 (64.4%) idiopathic and 31 (35.6%) congenital scoliosis. Among diff erent pathologies, 4 (04.59%) patients were having diastomyelia, tethered cord in 2 (2.29%) patients, syringomyelia in 10 (11.49%) and Chiari malformations in 2 (2.29%) patients; no patients having diplomyelia and lipoma, dural defects in 2 (2.29%), conus 9 (10.34%) and 1 (1.15%) foramen magnum compression. Among other rare anomalies, hydromyelia was found in 3 (3.44 %), tonsillar ectopia in 2 (2.29%) and OS odontoideum in 1 (1.14%). Only 5 (5.74%) of patients having neurology involved while having neurology intact. Conclusion: Patients with scoliosis having diff erent pathologies that cannot be determined on examination and X-rays. Pre-operative magnetic resonance imaging is essential to determine these diff erent types of pathologies found in these patients before undergoing any surgical intervention.