Anatomical changes in renal vessels and adjacent organs in patients with scoliosis: a retrospective CT- based observational study

Background Anatomical variations relevant to nephrectomy in patients with scoliosis have not been fully characterized. We aimed to quantify scoliosis-related changes in renal vessels and adjacent organs via computed tomography (CT). Methods In this retrospective single-center study, we evaluated 79 patients who underwent orthopedic surgery for scoliosis. Patients were grouped according to scoliosis severity into mild (Cobb angle: 10–60°), moderate (60–80°), and severe (≥ 80°) categories. The lengths of the renal arteries and veins were compared among these groups for both right- and left-convex curves. In patients with right convex scoliosis, we also examined how curve severity corresponded with liver coverage of the right kidney. Results Among the 79 patients (median age, 68 years; 19 men), 44 had right convex scoliosis, whereas 35 had left convex scoliosis. Scoliosis severity was mild in 65 (82%), moderate in 9 (11%), and severe in 5 (7%) patients. In the right convex scoliosis group, the median length of the right renal artery was significantly greater in the severe group (5.3 cm) than in the mild (4.1 cm) and moderate (4.2 cm) groups (P = 0.013 and P = 0.021). In left convex scoliosis, the renal vessel length did not differ significantly among the severity groups. The degree of liver coverage of the kidney was strongly correlated with the Cobb angle (r = 0.712, P = 0.006). Conclusions Anatomical changes in renal vessels and adjacent organs, particularly on the convex side, are observed in patients with scoliosis and become more pronounced as scoliosis worsens. Preoperative identification of these anatomical variations on CT may help mitigate surgical risks during nephrectomy and other retroperitoneal procedures.