X-rays: PA (posterior-anterior,
back-front), lateral (side), bending x-rays are almost always required.
Some patients with kyphosis will require hyperextension views (e.g.
extended backward).
MRI: Most adult patients
require an MRI so the surgeon can visualize the lumbar (low back) discs.
Patients with congenital scoliosis, under age 10, unusual curve patterns,
rapidly worsening curvature, severe back pain, neurofibromatosis (nerve
tumors), or other tumors are sent for MRI.
Myelogram and CAT Scan: These
tests tell the surgeon much about the patient's nerves, spinal cord and
bones using dye to outline the nerve structures.
Renal Sonogram: Patients with
congenital scoliosis have up to a 25-30% incidence of kidney or urological
abnormality. It is important to check renal function before surgery.
Echocardiogram: This test uses
ultrasound to examine the heart. It is required in patients with
congenital scoliosis (up to 10% of these patients have congenital heart
abnormalities), those with Marfan's syndrome (connective tissue disease),
and patients with a history of heart disease.
Other Tests: Some patients will
need an ophthalmological evaluation. Specifically, patients with Marfan's
syndrome need a slit lamp examination to examine the interior of the eyes
in which lens abnormalities may be found under magnification. Genetic
testing may be necessary for patients with other syndromes. The patient's
primary care physician or pediatrician may also order
tests.
