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Adult Lumbar Scoliosis: Underreported on Lumbar MR Scans

Adult Lumbar Scoliosis: Underreported on Lumbar MR Scans This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1962v1 31/5/832 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Anwar, Z. Articles by Yousem, D. M. PubMed PubMed Citation Articles by Anwar, Z. Articles by Yousem, D. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:832-837, May 2010 © 2010 American Society of Neuroradiology SPINE Adult Lumbar Scoliosis: Underreported on Lumbar MR Scans Z. Anwar a , E. Zan a , S.K. Gujar a , D.M. Sciubba a , L.H. Riley, III a , Z.L. Gokaslan a and D.M. Yousem a a From Johns Hopkins Hospital, Baltimore, Maryland. Please address correspondence to David M. Yousem, MD, MBA, Director of Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St/Phipps B-100F, Baltimore, MD 21287-2182; e-mail: dyousem1@jhu.edu BACKGROUND AND PURPOSE: Adult lumbar scoliosis is an increasingly recognized entity that may contribute to back pain. We investigated the epidemiology of lumbar scoliosis and the rate at which it is unreported on lumbar MR images. MATERIALS AND METHODS: The coronal and sagittal sequences of lumbar spine MR imaging scans of 1299 adult patients, seeking care for low back pain, were reviewed to assess for and measure the degree of scoliosis and spondylolisthesis. Findings were compared with previously transcribed reports by subspecialty trained neuroradiologists. Inter- and intraobserver reliability was calculated. RESULTS: The prevalence of adult lumbar scoliosis on MR imaging was 19.9%, with higher rates in ages >60 years (38.9%, P < .001) and in females (22.6%, P = .002). Of scoliotic cases, 66.9% went unreported, particularly when the scoliotic angle was <20° (73.9%, P < .001); 10.5% of moderate to severe cases were not reported. Spondylolisthesis was present in 15.3% (199/1299) of cases, demonstrating increased rates in scoliotic patients (32.4%, P < .001), and it was reported in 99.5% of cases. CONCLUSIONS: Adult lumbar scoliosis is a prevalent condition with particularly higher rates among older individuals and females but is underreported on spine MR images. This can possibly result in delayed 1) identification of a potential cause of low back pain, 2) referral to specialized professionals for targeted evaluation and management, and 3) provision of health care. The coronal "scout images" should be reviewed as part of the complete lumbar spine evaluation if dedicated coronal sequences are not already part of the spine protocol. Abbreviations: CI, confidence interval • OR, odds ratio Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Adult Lumbar Scoliosis: Underreported on Lumbar MR Scans

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A1962
Publisher site
See Article on Publisher Site

Abstract

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1962v1 31/5/832 most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Anwar, Z. Articles by Yousem, D. M. PubMed PubMed Citation Articles by Anwar, Z. Articles by Yousem, D. M. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:832-837, May 2010 © 2010 American Society of Neuroradiology SPINE Adult Lumbar Scoliosis: Underreported on Lumbar MR Scans Z. Anwar a , E. Zan a , S.K. Gujar a , D.M. Sciubba a , L.H. Riley, III a , Z.L. Gokaslan a and D.M. Yousem a a From Johns Hopkins Hospital, Baltimore, Maryland. Please address correspondence to David M. Yousem, MD, MBA, Director of Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St/Phipps B-100F, Baltimore, MD 21287-2182; e-mail: dyousem1@jhu.edu BACKGROUND AND PURPOSE: Adult lumbar scoliosis is an increasingly recognized entity that may contribute to back pain. We investigated the epidemiology of lumbar scoliosis and the rate at which it is unreported on lumbar MR images. MATERIALS AND METHODS: The coronal and sagittal sequences of lumbar spine MR imaging scans of 1299 adult patients, seeking care for low back pain, were reviewed to assess for and measure the degree of scoliosis and spondylolisthesis. Findings were compared with previously transcribed reports by subspecialty trained neuroradiologists. Inter- and intraobserver reliability was calculated. RESULTS: The prevalence of adult lumbar scoliosis on MR imaging was 19.9%, with higher rates in ages >60 years (38.9%, P < .001) and in females (22.6%, P = .002). Of scoliotic cases, 66.9% went unreported, particularly when the scoliotic angle was <20° (73.9%, P < .001); 10.5% of moderate to severe cases were not reported. Spondylolisthesis was present in 15.3% (199/1299) of cases, demonstrating increased rates in scoliotic patients (32.4%, P < .001), and it was reported in 99.5% of cases. CONCLUSIONS: Adult lumbar scoliosis is a prevalent condition with particularly higher rates among older individuals and females but is underreported on spine MR images. This can possibly result in delayed 1) identification of a potential cause of low back pain, 2) referral to specialized professionals for targeted evaluation and management, and 3) provision of health care. The coronal "scout images" should be reviewed as part of the complete lumbar spine evaluation if dedicated coronal sequences are not already part of the spine protocol. Abbreviations: CI, confidence interval • OR, odds ratio Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: May 1, 2010

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