Intraspinal abnormalities in MRI-evaluated congenital scoliosis: a systematic review and meta-analysis of prevalence, geographic variation, vertebral anomaly patterns, and Cobb angle
Year: 2026
Type: review
Study designs: Systematic Review, Meta-Analysis
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.
Institutions: King Saud University, Kuwait University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,950
OpenAlex ID: W7212366034