Intraspinal abnormalities in MRI-evaluated congenital scoliosis: a systematic review and meta-analysis of prevalence, geographic variation, vertebral anomaly patterns, and Cobb angle.
- 1Department of Orthopedic Surgery, College of Medicine, King Saud University, King Khalid Road, Riyadh 11461, Saudi Arabia.
- 2College of Medicine, King Saud University, King Khalid Road, Riyadh 11461, Saudi Arabia.
- 3Department of Surgery, College of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait.
Abstract
Background
Intraspinal abnormalities are common in congenital scoliosis, yet estimates and associations with vertebral anomaly patterns and curve severity remain inconsistent. This meta-analysis aimed to estimate the pooled prevalence of intraspinal abnormalities in congenital scoliosis patients and evaluate relationships with sex, geographic region, vertebral anomaly type, and Cobb angle.Methods
PubMed, Web of Science, Scopus, and Cochrane were searched through January 1, 2026. Observational studies of congenital scoliosis patients who underwent MRI and reported intraspinal abnormalities were included. Two reviewers independently screened studies and extracted data. Methodological quality was assessed using MINORS. (PROSPERO: CRD420251276010).Results
Eighteen studies reporting 4,463 patients were included; 1,474 had intraspinal abnormalities. Overall quality was moderate. Pooled prevalence was 35% (95% CI: 29%-40%), with substantial heterogeneity (I² = 91.1%) and a prediction interval of 16%-60%. Diastematomyelia was most frequent, followed by syringomyelia and tethered cord. Within each vertebral anomaly subgroup, pooled prevalence was 26% for failure of formation, 47% for failure of segmentation, and 40% for mixed defects. In unadjusted study-level comparisons, intraspinal abnormalities were associated with higher odds of failure of segmentation (odds ratio: 1.89 [95% CI: 1.39-2.56]) and mixed abnormalities (1.43 [1.09-1.88]). Cobb angle was higher in patients with intraspinal abnormalities than in those without, but the difference was not statistically significant (mean difference: 3.30° [95% CI: -1.53 to 8.13]; p = .1805).Conclusions
Intraspinal abnormalities affect one-third of congenital scoliosis patients. Failure of segmentation and mixed vertebral anomalies may identify higher-risk subgroups, supporting MRI-based evaluation for diagnosis and surgical planning.
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BibTeX
@article{algarni2026intraspinal,
title = {{Intraspinal abnormalities in MRI-evaluated congenital scoliosis: a systematic review and meta-analysis of prevalence, geographic variation, vertebral anomaly patterns, and Cobb angle.}},
author = {Nizar Algarni and Khalid Alrasheed and Faisal Alkhunein and Mohammed Alorayyidh and Rahaf Alrasheed and Yousef Marwan},
journal = {North American Spine Society journal},
year = {2026},
month = sep,
doi = {10.1016/j.xnsj.2026.100943},
url = {https://europepmc.org/article/MED/42921359},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intraspinal abnormalities in MRI-evaluated congenital scoliosis: a systematic review and meta-analysis of prevalence, geographic variation, vertebral anomaly patterns, and Cobb angle.
AU - Nizar Algarni
AU - Khalid Alrasheed
AU - Faisal Alkhunein
AU - Mohammed Alorayyidh
AU - Rahaf Alrasheed
AU - Yousef Marwan
PY - 2026
DA - 2026/09/12
JO - North American Spine Society journal
DO - 10.1016/j.xnsj.2026.100943
UR - https://europepmc.org/article/MED/42921359
AB - Background Intraspinal abnormalities are common in congenital scoliosis, yet estimates and associations with vertebral anomaly patterns and curve severity remain inconsistent. This meta-analysis aimed to estimate the pooled prevalence of intraspinal abnormalities in congenital scoliosis patients and evaluate relationships with sex, geographic region, vertebral anomaly type, and Cobb angle.Methods PubMed, Web of Science, Scopus, and Cochrane were searched through January 1, 2026. Observational studies of congenital scoliosis patients who underwent MRI and reported intraspinal abnormalities were included. Two reviewers independently screened studies and extracted data. Methodological quality was assessed using MINORS. (PROSPERO: CRD420251276010).Results Eighteen studies reporting 4,463 patients were included; 1,474 had intraspinal abnormalities. Overall quality was moderate. Pooled prevalence was 35% (95% CI: 29%-40%), with substantial heterogeneity (I² = 91.1%) and a prediction interval of 16%-60%. Diastematomyelia was most frequent, followed by syringomyelia and tethered cord. Within each vertebral anomaly subgroup, pooled prevalence was 26% for failure of formation, 47% for failure of segmentation, and 40% for mixed defects. In unadjusted study-level comparisons, intraspinal abnormalities were associated with higher odds of failure of segmentation (odds ratio: 1.89 [95% CI: 1.39-2.56]) and mixed abnormalities (1.43 [1.09-1.88]). Cobb angle was higher in patients with intraspinal abnormalities than in those without, but the difference was not statistically significant (mean difference: 3.30° [95% CI: -1.53 to 8.13]; p = .1805).Conclusions Intraspinal abnormalities affect one-third of congenital scoliosis patients. Failure of segmentation and mixed vertebral anomalies may identify higher-risk subgroups, supporting MRI-based evaluation for diagnosis and surgical planning.
SN - 2666-5484
ER -