Plasticity of Vertebral Wedge Deformities in Skeletally Immature Patients with Adolescent Idiopathic Scoliosis After Posterior Corrective Surgery

Overview

Journal BMC Musculoskelet Disord

Publisher Biomed Central

Specialties Orthopedics
Physiology

Date 2016 Oct 14

PMID 27733146

Citations 4

Authors

Takahiro Makino

Takashi Kaito

Yusuke Sakai

Shota Takenaka

Kazuomi Sugamoto

Hideki Yoshikawa

Affiliations

Soon will be listed here.

Abstract

Background: Vertebral bodies in patients with adolescent idiopathic scoliosis (AIS) usually have frontal wedge deformities. However, the plasticity of the deformed vertebrae in skeletally immature patients is unknown. The purpose of our study was to clarify the plasticity of vertebral deformities in skeletally immature patients with AIS by using in vivo three-dimensional (3D) analysis.

Methods: Ten female patients with AIS (mean age, 12.2 years; three patients, Lenke type 1; five patients, type 2; two patients, type 5) who underwent posterior fusion and whose Risser grade was ≤3 at surgery were included. Using computed tomography images (0.625-mm slice thickness) obtained 1 week and 1 year postoperatively, a total of seventy-three 3D bone models of vertebrae was made. The 3D bone models were made between the upper and lower end vertebrae within the main thoracic curve for patients with Lenke types 1 and 2 scoliosis, whereas they were made within the thoracolumbar/lumbar curve in patients with Lenke type 5 scoliosis. The height of the concave and convex sides in the anterior, middle and posterior parts of the vertebral bodies was measured using the original digital viewer, and the vertebral height ratio (VHR: concave/convex) was calculated. VHRs at 1 week and 1 year postoperatively were compared using the Wilcoxson signed-rank test. Differences were considered statistically significant at p < 0.05.

Results: VHR of the end vertebrae (n = 20) did not change postoperatively for any parts of the vertebral bodies. VHR of the vertebrae in the apical region (n = 28) also remained unchanged postoperatively. In contrast, VHR of the other vertebrae (n = 25) increased significantly in the anterior part postoperatively (from 0.938 to 0.961, p = 0.006).

Conclusions: The wedge deformity of vertebral bodies showed a reshaping potential towards a symmetrical configuration in the region other than end and apex, although no plasticity of the vertebrae was observed in the apical region even in skeletally immature patients with AIS.

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References

Hayashi K, Upasani V, Pawelek J, Aubin C, Labelle H, Lenke L . Three-dimensional analysis of thoracic apical sagittal alignment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2009; 34(8):792-7. DOI: 10.1097/BRS.0b013e31818e2c36. View

Weinstein S, Dolan L, Cheng J, Danielsson A, Morcuende J . Adolescent idiopathic scoliosis. Lancet. 2008; 371(9623):1527-37. DOI: 10.1016/S0140-6736(08)60658-3. View

Fujimori T, Iwasaki M, Nagamoto Y, Ishii T, Sakaura H, Kashii M . Three-dimensional measurement of growth of ossification of the posterior longitudinal ligament. J Neurosurg Spine. 2011; 16(3):289-95. DOI: 10.3171/2011.11.SPINE11502. View

Ogura Y, Kou I, Miura S, Takahashi A, Xu L, Takeda K . A Functional SNP in BNC2 Is Associated with Adolescent Idiopathic Scoliosis. Am J Hum Genet. 2015; 97(2):337-42. PMC: 4573260. DOI: 10.1016/j.ajhg.2015.06.012. View

Wang S, Qiu Y, Zhu Z, Ma Z, Xia C, Zhu F . Histomorphological study of the spinal growth plates from the convex side and the concave side in adolescent idiopathic scoliosis. J Orthop Surg Res. 2007; 2:19. PMC: 2186319. DOI: 10.1186/1749-799X-2-19. View

Lenke L, Betz R, Harms J, Bridwell K, Clements D, Lowe T . Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001; 83(8):1169-81. View

Parent S, Labelle H, Skalli W, De Guise J . Vertebral wedging characteristic changes in scoliotic spines. Spine (Phila Pa 1976). 2004; 29(20):E455-62. DOI: 10.1097/01.brs.0000142430.65463.3a. View

Scherrer S, Begon M, Leardini A, Coillard C, Rivard C, Allard P . Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis. PLoS One. 2013; 8(8):e71504. PMC: 3744570. DOI: 10.1371/journal.pone.0071504. View

Matsuo Y, Kaito T, Iwasaki M, Sugiura T, Fujimori T, Nagamoto Y . 3D morphometric analysis of laminae and facet joints in patients with degenerative spondylolisthesis. Mod Rheumatol. 2015; 25(5):756-60. DOI: 10.3109/14397595.2015.1008673. View

10.

Begon M, Scherrer S, Coillard C, Rivard C, Allard P . Three-dimensional vertebral wedging and pelvic asymmetries in the early stages of adolescent idiopathic scoliosis. Spine J. 2014; 15(3):477-86. DOI: 10.1016/j.spinee.2014.10.004. View

11.

Modi H, Suh S, Song H, Yang J, Kim H, Modi C . Differential wedging of vertebral body and intervertebral disc in thoracic and lumbar spine in adolescent idiopathic scoliosis - A cross sectional study in 150 patients. Scoliosis. 2008; 3:11. PMC: 2527554. DOI: 10.1186/1748-7161-3-11. View

12.

Meir A, McNally D, Fairbank J, Jones D, Urban J . The internal pressure and stress environment of the scoliotic intervertebral disc--a review. Proc Inst Mech Eng H. 2008; 222(2):209-19. DOI: 10.1243/09544119JEIM303. View

13.

Meir A, Fairbank J, Jones D, McNally D, Urban J . High pressures and asymmetrical stresses in the scoliotic disc in the absence of muscle loading. Scoliosis. 2007; 2:4. PMC: 1820774. DOI: 10.1186/1748-7161-2-4. View

14.

Kou I, Takahashi Y, Johnson T, Takahashi A, Guo L, Dai J . Genetic variants in GPR126 are associated with adolescent idiopathic scoliosis. Nat Genet. 2013; 45(6):676-9. DOI: 10.1038/ng.2639. View

15.

Liljenqvist U, Allkemper T, Hackenberg L, Link T, Steinbeck J, Halm H . Analysis of vertebral morphology in idiopathic scoliosis with use of magnetic resonance imaging and multiplanar reconstruction. J Bone Joint Surg Am. 2002; 84(3):359-68. DOI: 10.2106/00004623-200203000-00005. View

16.

Stokes I . Mechanical effects on skeletal growth. J Musculoskelet Neuronal Interact. 2005; 2(3):277-80. View

17.

Schlosser T, van Stralen M, Brink R, Chu W, Lam T, Vincken K . Three-dimensional characterization of torsion and asymmetry of the intervertebral discs versus vertebral bodies in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2014; 39(19):E1159-66. DOI: 10.1097/BRS.0000000000000467. View

18.

Kuklo T, Potter B, Lenke L . Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate?. J Spinal Disord Tech. 2005; 18(2):139-47. DOI: 10.1097/01.bsd.0000159033.89623.bc. View

19.

Newton P, Fujimori T, Doan J, Reighard F, Bastrom T, Misaghi A . Defining the "Three-Dimensional Sagittal Plane" in Thoracic Adolescent Idiopathic Scoliosis. J Bone Joint Surg Am. 2015; 97(20):1694-701. DOI: 10.2106/JBJS.O.00148. View

20.

Sarwark J, Aubin C . Growth considerations of the immature spine. J Bone Joint Surg Am. 2007; 89 Suppl 1:8-13. DOI: 10.2106/JBJS.F.00314. View