The correlation of preoperative three-dimensional computed tomography reconstructions with operative findings in congenital scoliosis

Study Design. A retrospective radiographic and chart review of patients who underwent computed tomography with three- dimensional reconstructions before single stage anterior and posterior hemivertebra excision. Objective. To assess the efficacy of three- dimensional computed tomography reconstructions in accurately identifying congenital vertebral anomalies. Summary of Background Data. Computed tomography allows better imaging of bony architecture than plain films alone. Three- dimensional computed tomography reconstructions facilitate visualization of complex anatomic structures. The correlation of three- dimensional computed tomography reconstructions with the intraoperative anatomy of hemivertebra has not been reported. Methods. Fifteen patients were retrospectively investigated. The plain films, three- dimensional computed tomography reconstruction scans, and operative reports were each blindly reviewed to determine the anatomy. We then correlated the findings of each imaging study with the intraoperative anatomy. Results. Compared with intraoperative findings in 15 cases, three- dimensional reconstructions of computed tomography scans accurately predicted anterior and posterior vertebral anomalies in all cases. Plain radiographs accurately predicted anterior anatomy; however, 11 out of 12 posterior anomalies were not seen on plain film evaluation. Conclusions. Three- dimensional reconstructions of computed tomography scans are more helpful than plain films in visualizing posterior vertebral anomalies associated with hemivertebra. Unexpected anomalies may be encountered posteriorly when plain films alone are used in surgical planning.