Evaluation of Cerebrospinal Fluid Flow by Nuclear Magnetic Resonance in Adolescent Idiopathic Scoliosis

Abstract Objectives Zebrafish research highlighted the critical role of cilia-driven cerebrospinal flow (CSF) in spine development, establishing CSF flow irregularities as an underlying biological cause of idiopathic scoliosis (IS). In this study, our objective was to assess and compare the cerebrospinal flow (CSF) of two populations (healthy adolescents and adolescents with IS) in order to detect anomalies similar to those in the animal model. Methods We conducted a prospective monocentric case-control study with 6 months of cohort follow-up. We enrolled 34 and 31 adolescents with and without IS, respectively. CSF flow was assessed using a 3T MRI scanner with axial phase-contrast flow sequences at the level of the mesencephalic aqueduct (MA), the 2nd cervical vertebra (C2), and the 7th thoracic vertebra (T7). Results Our results revealed no statistically significant difference in the CSF circulation characteristics (stroke volume, flow, velocity) at all three levels between the two groups. In the IS group, there was a positive correlation between the maximum CSF velocity at C2 and the Cobb angle (p = 0.014). There was also a positive correlation between the stroke volumes at the MA and C2 (p = 0.033), and between the CSF stroke volumes at C2 and T7 (p = 0.0012). Conclusion Our results revealed no difference in CSF flow characteristics between healthy and IS subjects. Further investigations would be pertinent to clarify the role of cerebrospinal fluid in correct spinal morphogenesis in humans.