The incidence of intraspinal abnormalities and other systemic anomalies in patients with lumbosacral hemivertebra

English Keywords:Lumbosacral hemivertebra  Intraspinal abnormality  Extraspinal anomaly

English Abstract:

  【Abstract】 Objectives: To investigate the incidence of intraspinal abnormalities and other systemic anomalies in congenital scoliosis(CS) patients secondary to lumbosacral hemivertebra. Methods: From January 2002 to May 2016, the clinical data of 75 CS patients with lumbosacral hemivertebra who received correction surgery were reviewed. There were 35 males and 40 females with a mean age of 13.8±9.1(3-41) years. All of the patients underwent magnetic resonance image(MRI) of the whole spine, echocardiography and urogenital ultrasound before surgery. The incidences of intraspinal abnormalities and other systemic anomalies were analyzed. The patients were grouped according to gender, side, segmentation and number of hemivertebrae. The incidences of intraspinal and other systemic anomalies in different groups were compared. Intraspinal abnormalities were classified as diastematomyelia, tethered cord, syringomyelia, Chiari malformation and low conus. And other systemic anomalies were recorded including cardiac abnormalities, genitourinary abnormalities, discrepancy of lower extremities and sacrum dysplasia. Results: The incidence of intraspinal abnormalities was 14.67%(11/75), including diastematomyelia 6.67%(5/75), tethered cord 5.33%(4/75) syringomyelia 4.0%(3/75), Chiari malformation 1.33%(1/75) and low conus 1.33%(1/75). Three patients presented with 2 intraspinal malformations. There was no significant statistical difference in the incidence of intraspinal abnormalities between males and females, nor between left side and right side hemivertebra, nor between fully-segmented, semi-segmented and non-segmented hemivertebra, nor between single and multiple hemivertebrae(P>0.05). The incidence of other organ anomalies in patients with lumbosacral hemivertebra was 20%(15/75), with cardiac abnormalities 6.67%(5/75), genitourinary abnormalities 4.0%(3/75), discrepancy of lower extremities 4.0%(3/75) and sacrum dysplasia 6.67%(5/75), respectively. No significant statistical difference of the incidence of other systemic anomalies was found between males and females, nor between left side and right side hemivertebra, nor between fully-segmented, semi-segmented and non-segmented hemivertebra, nor between single and multiple hemivertebrae(P>0.05). Conclusions: The incidence of intraspinal abnormalities is 14.67% in CS patients with lumbosacral hemivertebra, while the incidence of other organ anomalies is 20%. Sacrum dysplasia, discrepancy of lower extremities, cardiac abnormalities and genitourinary abnormalities are the most common other systemic anomalies.