We retrospectively reviewed the magnetic resonance imaging studies that
had been made for ninety-five patients who had idiopathic scoliosis. We
wished to determine if we could identify any criteria that should be met
before these studies are performed. The study group included thirty-one
male patients and sixty-four female patients. The average age at the time
of the imaging study was thirteen years (range, one to twenty-eight years).
The average curve was 41 degrees (range, 11 to 95 degrees). Fourteen
patients were seen to have an intraspinal abnormality on the imaging study:
twelve had a syrinx, one had a syrinx and an astrocytoma of the spinal
cord, and one had dural ectasia. Five of the eight patients who were less
than eleven years old and who had a left thoracic curve had an intraspinal
abnormality on the imaging study, but this combination of factors did not
indicate the need for operative intervention. Four of the intraspinal
abnormalities in the fourteen patients necessitated neurosurgical
intervention; if the criteria for obtaining the imaging study had been
restricted to neck pain and headache--particularly with exertion--and
neurological findings such as ataxia, weakness, and a cavus foot, these
abnormalities would have been diagnosed.