Low Sensitivity of Neurological Examination, Curve Laterality, and Thoracic Kyphosis for Detecting Chiari I Malformation and Syrinx in Operative Pediatric Scoliosis

The authors investigate the sensitivity of neurological examinations, curve laterality, and thoracic kyphosis in detecting Chiari malformation type I (CM1) and syrinx in pediatric patients undergoing surgery for scoliosis. They found that these screening criteria have relatively low sensitivity, with a significant proportion of patients presenting with normal neurological exams and other typical metrics. The findings suggest that surgeons should be cautious in relying solely on these indicators when deciding on preoperative MRI for scoliosis surgery.