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

Background Anatomical variations relevant to renal hilar exposure in patients with scoliosis remain incompletely characterized. We aimed to quantify scoliosis-related changes in renal vessels and adjacent organs using computed tomography (CT), recognizing that these anatomical data can only indirectly inform surgical planning. Methods In this retrospective single-center study, we evaluated 78 patients who underwent orthopedic surgery for scoliosis. Patients were grouped into pre-specified Cobb-angle strata of 10° to < 60°, 60° to < 80°, and ≥ 80° for descriptive anatomical analysis. These strata were not intended to represent a standard orthopedic severity classification. We compared renal artery and vein lengths across these strata for both right- and left-convex curves. In patients with right-convex scoliosis, we also examined how the Cobb angle and vertebral rotation related to liver coverage of the right kidney. Results Among the 78 patients (median age, 67 years; 19 men), 44 had right-convex scoliosis, and 34 had left-convex scoliosis. The 10° to < 60°, 60° to < 80°, and ≥ 80° Cobb-angle strata included 64 (82%), 9 (11%), and 5 (7%) patients, respectively. In the right-convex scoliosis group, right renal artery length differed across Cobb-angle strata (Kruskal–Wallis test, P = 0.031). Exploratory post hoc analysis showed a difference between the 10° to < 60° and ≥ 80° strata, whereas the other pairwise comparisons were not statistically significant. In the left-convex scoliosis group, renal vessel length did not differ significantly across the Cobb-angle strata. Liver coverage of the right kidney was positively correlated with both vertebral rotation ( r = 0.531, P < 0.001) and the Cobb angle ( r = 0.506, P < 0.001). Conclusions In this adult-dominant orthopedic scoliosis cohort, higher Cobb-angle strata within the right-convex group were associated with longer projected right renal artery measurements, and hepatic coverage of the right kidney was associated with both vertebral rotation and the Cobb angle.