Comparison of conus medullaris levels and spinopelvic\rparameters between patients with adolescent idiopathic\rscoliosis, tethered cord syndrome, and healthy adolescents

Aim: The tension of the spinal cord may pose a risk in terms of neurological damage during deformity correction of spine surgeries. Conus medullaris level can provide information\rabout the tension of the spinal cord. However there is lack of information in the literature\rabout the conus medullaris level in idiopathic scoliosis patients. This study aimed to compare conus medullaris levels and spinopelvic parameters among patients with adolescent\ridiopathic scoliosis (AIS), tethered cord syndrome with AIS, and healthy controls.\rMaterials and Methods: We retrospectively recruited fifty patients with AIS (mean\rage 14.3±2.0 years), forty-two patients with tethered cord syndrome with AIS (mean age\r13.6±4.8 years), and fifty patients with no spinal abnormality (mean age 14.5±2.4 years).\rFor the evaluation of and comparison of the patients, Risser stage, spinopelvic parameters\r(Cobb angle, lumbar lordosis angle, thoracal kyphosis angle, lumbosacral angle, thoracal\rtilt, T1-pelvis angle, sacral slope, sagittal and coronal balance, lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence), and conus medullaris levels were used. Conus medullaris\rlevels were measured on sagittal magnetic resonance imaging (MRI) T2-weighted sections,\rand spinopelvic parameters were measured on lateral whole-spine radiographs.\rResults: Conus medullaris termination levels were significantly lower in the tethered cord\rsyndrome with AIS group (p < 0.001) and were not significantly different between the\rAIS group and healthy individuals (p = 0.680). No significant differences were observed\rin the Risser stage, Cobb angle, lumbar lordosis, thoracal kyphosis, lumbosacral angle,\rthoracal tilt, T1-pelvis angle, sacral slope, sagittal balance, and coronal balance between\rthe tethered cord with AIS and AIS groups (all p > 0.05). Lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence parameters were significantly higher in the tethered cord\rwith AIS group (all p < 0.05 ).\rConclusion: This study demonstrated that the distribution of the conus locations in AIS\rpatients was similar to that in the healthy control group. Lumbar tilt, pelvic obliquity,\rpelvic tilt, and pelvic incidence parameters were significantly higher in the tethered cord\rsyndrome with AIS group.\r