Diagnosis of adult scoliosis

What is it?

Spine teleradiography (TeleRX) in orthostasis with standard or low-dose-radiation (EOS) technique allows to evaluate scoliosis in anteroposterior and laterolateral projection. The acquisition of these two planes plays a major role, as it allows to study the sagittal and coronal balance, measure in quantitative terms the degrees of the principal curves and design the pre-operative planning. The correct reconstruction of the sagittal profile of the column allows to minimize the risk of junctional pathologies that require extension of the arthrodesis in both proximal and distal sense.

Computed tomography (CT) is a second level examination, useful to highlight osteo-cartilaginous structures. Allows three-dimensional evidence of root compressions, spinal canal stenosis and associated bone lesions.

Nuclear magnetic resonance imaging (NMR) is used for the study of the disc-radicular complex, paravertebral soft tissues, and in preoperative planning of vascular and splanchnic structures in cases of circumferential arthrodesis.

When is this exam indicated?

These examinations are necessary to evaluate: the degree of defromity, associated pathologies (lumbar stenosis, radicular compressions, spinal cord compressions, fractures), the indication for surgical treatment, the extent of surgical correction to restore the sagittal and coronal balance.

How is it performed?

The teleradiography of the rachis (TeleRX) in orthostasis with standard technique is carried out with X-rays obtaining an image of the skeleton defined in 2 projections. Low-dose-radiation spinal teleradiography (EOS) allows to perform the same examination but with a much lower quantity of radiation and with the possibility to perform three-dimensional reconstructions of the column or of the whole skeleton.

Contraindications

Teleradiography of the spine (TeleRX) or EOS and CT are contraindicated for pregnant women. Major contraindications for MRI are: MRI incompatible compatible metals, metal shavings, dentures, pregnant status, pace-makers, intrauterine devices (IUDs). In case of use of contrast medium (both iodine for CT and gadolinium for MRI), which happens quite rarely, the patient will have to follow an appropriate anti-allergic preparation.

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