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Preoperative urinary tract obstruction in scoliosis patients
Author(s) -
Suzuki Shigeru,
Kotani Toshiaki,
Mori Kazuetsu,
Kawamura Ken,
Ohtake Akira
Publication year - 2017
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.13115
Subject(s) - medicine , urinalysis , urinary system , scoliosis , magnetic resonance imaging , asymptomatic , renal function , urology , renal pelvis , radiology , surgery
Background While the association between scoliosis and cardiac and respiratory function impairments has been well characterized in clinical practice and research, the potential effect of scoliosis on urinary tract structure and renal function has received little attention. Therefore, the purpose of this study was to evaluate the preoperative clinical characteristics of urinary tract structure and renal function in pediatric patients with idiopathic scoliosis, using a combination of blood tests, urinalysis, and imaging. Methods Preoperative measures of urinary tract structure and renal function were obtained for 16 patients, 13–17 years old, scheduled for corrective surgery for idiopathic scoliosis. Preoperative assessment included blood test and urinalysis, combined with structural imaging on ultrasound ( US ), magnetic resonance imaging ( MRI ), magnetic resonance urography ( MRU ), and radioisotope tracing ( RI ), using technetium‐99 m mercaptoacetyltriglycine ( 99m Tc‐ MAG 3). Differences in blood and urine tests between patients with and without urinary tract obstruction ( UTO ) were evaluated for significance using Mann‐Whitney U test. Results For all 16 patients, blood tests and MRU were within normal limits. Dilatation of the renal pelvis was identified on US in eight patients (50.0%). UTO was identified on RI in six patients (37.5%). UTO was associated with elevated β2‐microglobulin concentration. Urinary β2‐microglobulin concentration >0.7 μg/mg Cr differentiated patients with UTO from those without UTO , with a sensitivity of 100% and specificity of 70%. Conclusions β2‐Microglobulin concentration may be a useful marker to screen for asymptomatic UTO in patients with idiopathic scoliosis.