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Meta-Analysis
. 2020 Oct 21;15(1):485.
doi: 10.1186/s13018-020-02015-8.

Incidence of intraspinal abnormalities in congenital scoliosis: a systematic review and meta-analysis

Xudong Wang  1 , Yangke Yu  1 , Ningning Yang  1 , Lei Xia  2
Affiliations
Meta-Analysis

Incidence of intraspinal abnormalities in congenital scoliosis: a systematic review and meta-analysis

Xudong Wang et al. J Orthop Surg Res. .

Abstract

Objective: This is the first systematic review and meta-analysis on the overall incidence of intraspinal abnormalities in patients with congenital scoliosis (CS) and potential influencing factors.

Methods: We searched three large electronic databases (PubMed, EMBASE, and Cochrane Library) for potentially relevant studies. The quality of the included studies was assessed independently by two authors using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Data on the number of CS patients, number of CS patients with intraspinal abnormalities, sex of the patients, and CS types were extracted from the included studies. R software was used to pool and analyze all the extracted data.

Results: This meta-analysis included 10 articles, and 671 of 1863 CS patients undergoing magnetic resonance imaging (MRI) examinations were identified to have intraspinal abnormalities. The overall incidence of intraspinal abnormalities in the patients with CS was 37% (95% CI, 29-45%). Diastematomyelia was the most common intraspinal abnormality and was detected in 45.60% of the patients with intraspinal abnormalities (306/671). The remaining intraspinal abnormalities included syringomyelia (273/671, 40.69%), tethered cord (190/671, 28.32%), low conus (58/671, 8.64%), intraspinal mass (39/671, 5.81%), Chiari malformation (32/671, 4.77%), fatty filum (27/671, 4.02%), spina bifida (occulta excluded) (17/671, 2.53%), tumor (17/671, 2.53%), cyst (12/671, 1.79%), syringomyelus (4/671, 0.60%), dural ectasia (1/671, 0.15%), and undiagnosed cord MRI hyperintensity (1/671, 0.15%). The patient's sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients (all P > 0.05).

Conclusions: This meta-analysis revealed that the overall incidence of intraspinal abnormalities detected by MRI in CS patients was 37%. Diastematomyelia was the most common intraspinal abnormality. The patient's sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients.

Keywords: Congenital scoliosis; Intraspinal abnormalities; Magnetic resonance imaging; Meta-analysis.

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Conflict of interest statement

None of the authors have potential conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow diagram of the study selection process
Fig. 2
Fig. 2
The overall incidence of intraspinal abnormalities in patients with congenital scoliosis
Fig. 3
Fig. 3
The pooled incidence of intraspinal abnormalities in male patients with congenital scoliosis
Fig. 4
Fig. 4
The pooled incidence of intraspinal abnormalities in female patients with congenital scoliosis
Fig. 5
Fig. 5
The pooled incidence of intraspinal abnormalities in congenital scoliosis patients with a failure of formation
Fig. 6
Fig. 6
The pooled incidence of intraspinal abnormalities in congenital scoliosis patients with a failure of segmentation
Fig. 7
Fig. 7
The pooled incidence of intraspinal abnormalities in congenital scoliosis patients with mixed abnormalities
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