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. 2025 Jun 14;17(6):e86003.
doi: 10.7759/cureus.86003. eCollection 2025 Jun.

Preoperative Evaluation of Adolescent Idiopathic Scoliosis: The Relevance of Routine Magnetic Resonance Imaging

Majdi M Abu Awida  1 , Awni A Shyyab  1 , Shaher A Aletan  1 , Mohammad A Adamat  1 , Heba O Al Ofieshat  2 , Ashraf A Al-Tamimi  3 , Monther M Alessa  4
Affiliations

Preoperative Evaluation of Adolescent Idiopathic Scoliosis: The Relevance of Routine Magnetic Resonance Imaging

Majdi M Abu Awida et al. Cureus. .

Abstract

Introduction The evidence for using preoperative magnetic resonance imaging (MRI) to assess the whole spine in patients with adolescent idiopathic scoliosis (AIS) is not well established. However, it is routine to perform whole-spine MRI in patients with scoliosis who are scheduled to undergo surgical correction in our center to detect occult neural axis abnormalities that may not present with neurological symptoms but could influence surgical planning and safety. Method A retrospective single-center and descriptive evaluation of the medical records of AIS patients aged 10 to 18 who were admitted for surgical treatment at our institution between 2017 and 2022 to evaluate the value of the routine preoperative MRI. Descriptive statistics were utilized to analyze the data. Independent t-tests and chi-square tests (X²) or Fisher's exact tests were employed to compare groups as appropriate. Results Out of 106 patients evaluated, 10 patients (9.4%) were found to have neural axis abnormalities. Abnormal MRI findings were significantly more common in males than in females and were associated with increased thoracic kyphosis. However, there were no significant differences in the other parameters that were measured. Conclusion Even in the absence of neurological symptoms to identify any abnormalities of the neural axis, MRI may be useful in making decisions for the surgical treatment of AIS patients, particularly for those with risk factors such as male sex or exaggerated kyphosis.

Keywords: adolescent idiopathic scoliosis; magnetic resonance image; neuraxial abnormities; preoperative; prevalence.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Review Board at Royal Medical Services issued approval 4. This study was approved by the Ethics Review Board at Royal Medical Services. under ethical approval number (4). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. A fifteen-year-old female AIS patient with syrinx seen at C6–C7 on preparative MRI.
A: Chest X-ray showing scoliosis, B: T2 sagittal (cervical and thoracic) showing C6-C7 syrinx, C: axial T2 C6-C7 syrinx AIS: Adolescent idiopathic scoliosis
Figure 2
Figure 2. An 11-year-old male AIS patient with Dural ectasia seen at thoracic region with possible foraminal cyst seen left side of upper thoracic region measures about 15 mm on preoperative MRI.
A: Chest X-ray showing scoliosis, B and C: sagittal MRI showing left lower cervical dural ectasia seen in the left upper thoracic region measuring 15 mm
See this image and copyright information in PMC

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