Diagnosis and treatment of congenital scoliosis associated with intraspinal mass

English Keywords:Congenital scoliosis  Intraspinal mass  Diagnosis  Treatment

English Abstract:

  【Abstract】 Objectives: To analyze the clinical characteristics of congenital scoliosis associated with intraspinal mass, and to investigate the incidence, clinical manifestations, imaging characteristics and surgical outcomes. Methods: The clinical data of congenital scoliosis patients associated with intraspinal mass who underwent surgical treatment from January 2007 to June 2016 in Department of Orthopedics, Xijing Hospital were retrospectively reviewed. There were 2 females and 5 males with an average age of 19.14±7.52 years (range, 11-31 years). MRI showed the intraspinal masses were all located at thoracic spine. Five of the intraspinal masses were intramedullary, one was intradural extramedullary and one was both of the intramedullary and intradural extramedullary. All of the patients were treated with one-stage intraspinal mass resection and scoliosis correction. Clinical evaluation included scoliosis correction rate, incidence of complications and recurrence rate. Results: Patients were observed for a minimum of 24 months after initial surgical treatment with an average follow-up of 49.71±32.90 months(range, 27-99 months). Congenital scoliosis associated with intraspinal mass accounted for 1.41% of congenital scoliosis. MRI could show the location of all intraspinal mass and four patients had the same pathological　results. Postoperative pathological　examination showed two cases of epidermoid cyst, one case of dermoid cyst, one case of bronchogenic cyst, two cases of teratoma and one case of pilomyxoid astrocytoma. The major coronal curve correction rate was (55.05±18.75)% and the major sgittal curve correction rate was (41.53±19.43)%. There was no obvious loss of correction at final follow-up. There were one patient with transient neurological deterioration and one patient with cerebrospinal fluid leakage. One patient recurred at the 5-year follow-up in this study. There was no paralysis or permanent nerve damage. Conclusions: The incidence of congenital scoliosis associated with intraspinal mass is low. Diagnosis mainly depends on clinical manifestations, imaging characteristics and pathological examination. Simultaneous intraspinal mass resection and scoliosis correction appears to be safe and effective.