The Application Of Three Dimension Curve Planar Reconstruction Technique With MR In Spinal Scoliosis

Objective: To study the clinical value of three dimension curve planar reconstruction technique with MR in spinal scoliosis.Methods: Between December 2008 and February 2009, 20 patients with scoliosis at the age of 6 to 19 years (mean: 13.7 years) were including 8 male, and 12 female. X-ray and three dimension curve planar reconstruction technique with magnetic resonance imaging of the spinal cord were performed as part of their preoperative work-up and all the patients were admitted for spinal surgery. The angle of scoliosis was measured by Cobb's method and the incidence of spinal cord malformation and vertebral deformity, predilection site of each kind of spinal cord malformation and vertebral deformity were measured respectively. And then the image findings were compared to intraoperative anatomy descriptions.Result: According to the intention-to-treat analysis, all the 20 patients were included into the result analysis. The Cobb's angle of scoliosis ranged from 38°to 142°(mean 83.2°), and the Cobb's angle of kyphosis was 30°~156°(mean 73.5°), the operating time was 3~7h, mean 4.6h. The blood loss was 400~1500ml with mean 940ml. 1. Curve location is defined by its center, known as the apex, which is the most lateral disc or vertebra of the curve. Usually the apical vertebra is also the most horizontal. Scoliosis can be classified as thoracic (T2-T11-12 disc), thoraco- umber (T12-L1) and lumbar (L1-2 disc-L4). Vertebral deformity was detected in thoracic segment (10 cases), thoraco-lumber segment (8 cases) and lumber segment (2 cases) of spine.2. Off these patients, 15 cases were hemivertebrae deformity, 1 case were severe kyphosis, 9 cases with solitary hemiverterbrea, 4 cases with multiple hemivertebrea, 1 case with mixed vertebral deformity.3. There were 14 cases with spinal cord malformation in 20 patients with scoliosis, which includes 5 cases with syringomyelia, 3 cases of diastomyelia, 2 cases of syringomyelia & diastomyelia, 3 cases of Chiari malformation and 1 case of low-set of spinal cord or tethered syndrome.The measurements and descriptions of the scoliosis by three dimension curve planar reconstruction with MR were similar to that by the intraoperative findings.Conclusion: Three dimension curve planar reconstruction with MR of the spine can visually reflect the real condition of spine deformities, help preoperative evaluation and surgical procedure designing, it is appealing technique of surgical correction and accurate instrumentation for the severe congenital spine deformities.