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Current practices in MRI screening in early onset scoliosis.

Spine Deform

January 2025

Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.

Purpose: Early onset scoliosis (EOS) has traditionally been an indication for MRI because of its association with neural axis abnormalities (NAAs). Because these abnormalities are often clinically silent and concerns regarding sedation in young children are growing, routine MRI for EOS is debated. This study investigates the current practices of EOS MRI screening among surgeons in the Pediatric Spine Study Group (PSSG).

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Background And Objective: Neurofibromatosis-1 (NF1) dystrophic scoliosis is a challenging disease to manage surgically, with multiplanar curves progressing rapidly and unpredictably. Conservative management with bracing is often unsuccessful, and many patients necessitate instrumented fusion to halt progression of their curves. In rare cases, patients can present with spontaneous vertebral subluxation, significantly complicating the surgical management of this already complex disease process.

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Intramedullary schwannomas are a type of benign spinal cord tumor that originates from the Schwann cells of the nerve sheath. They are relatively rare and typically occur within the spinal cord itself, rather than in the surrounding tissue. Treatment options for cervical intramedullary schwannomas include surgical removal of the tumor, radiation therapy, and observation.

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Background: The management of spinal deformities in patients with NF-1 is challenging. The study aimed to assess the outcomes of the surgical treatment of spine deformities in children with neurofibromatosis type 1 with our treatment approach.

Methods: A retrospective single-center study on pediatric patients with spinal deformities associated with NF-1 who received surgical treatment between 2006 and 2024.

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Primary spinal intradural malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, especially in children with a non-neurofibromatosis background. Scarce pediatric data exist with regard to such tumors. A 4-year-old child with a history of spastic limb weakness was operated for a foramen magnum spinal lesion (intradural and extradural) with imaging suggestive of schwannoma; the histopathology, however, was that of a MPNST.

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