Journal of pediatric orthopedics
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Thirty consecutive patients with congenital spinal deformity underwent magnetic resonance imaging (MRI) to determine the incidence of occult intraspinal anomaly. These congenital spinal deformities included 29 cases of congenital scoliosis and one case of congenital kyphosis. Physical examination findings and plain radiographs were reviewed in an attempt to correlate these findings with subsequent intraspinal pathology. ⋯ In patients with a congenital spinal deformity, we found nine (30%) of 30 to have an associated anomaly within the spinal canal. Only three of these nine had plain radiographs and physical examination findings suggestive of their subsequent MRI findings. Given the poor correlation between findings on physical examination, plain radiographs, and subsequent occult intraspinal anomalies on MRI, we believe that MRI is helpful in evaluating patients with congenital spinal anomalies.
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To define the risk of spinal deformity after selective dorsal rhizotomy (SDR) for the treatment of spasticity due to cerebral palsy, 43 patients were reviewed before and after the procedure. The average length of follow-up was 5.3 years with a range of 2-9 years. Scoliosis was present in three patients before rhizotomy. ⋯ Five patients were placed in braces, and three patients went on to have surgical stabilization of their deformities. For the entire group, the risk of developing a structural spinal deformity was 36%, with 6% requiring stabilization at an average of 4.9 years after SDR. Older age, more severe neurologic impairment, and preexisting spinal deformity seems to increase this risk.