Vertebral Wedging Characteristic Changes in Scoliotic Spines

Study Design: A morphometric analysis of vertebral wedging in vertebrae from scoliotic specimens.

Objective: To quantify the vertebral body changes in 30 anatomic specimens affected by a scoliotic deformity.

Summary Of Background Data: Only a few studies have evaluated the exact changes occurring at the level of the vertebral body in scoliotic spines. Most are observational studies of rare scoliotic specimens presenting major curvatures. The orientation of vertebral wedging is important for the planning of corrective surgery, performing vertebral osteotomy, and the evaluation of possible growth modulation.

Materials And Methods: Thirty scoliotic specimens with curves presenting various degrees of severity were studied using a three-dimensional digitizing protocol developed to create a precise three-dimensional reconstruction of the vertebrae. Every scoliotic specimen was then matched with a normal specimen, and comparisons were made on the vertebral body parameters both for thoracic and lumbar vertebrae. Analysis of variance and t test calculations were performed to identify significant differences with P = 0.05.

Results: A total of 471 vertebrae from scoliotic spines and 510 vertebrae from normal specimens were measured. Vertebral wedging increased progressively towards the apex of the curve and was maximal at the apex. Vertebral wedging was more prominent in the frontal plane, and there was minimal wedging in the sagittal plane. Vertebral heights were significantly different at T3 and T4 for the upper adjacent curve and at T6-T8 for a typical right thoracic curve, with smaller heights located on the concavity of the curve. No changes were observed on the convexity of the curve.

Conclusion: Vertebral wedging is an essential component of the scoliotic deformity. The present study provides critical information for corrective surgery and vertebral osteotomy, as vertebral wedging occurs primarily in the frontal plane. Accurate knowledge of this deformity should also provide new insight into corrective surgical strategies aiming at growth modulation and more efficient surgical correction.