Imbalanced Development of Anterior and Posterior Thorax is a Causative Factor Triggering Scoliosis

Overview

Journal J Orthop Translat

Publisher Elsevier

Specialty Orthopedics

Date 2019 Jun 14

PMID 31194037

Citations 4

Authors

Bo Chen

Qiaoyan Tan

Hangang Chen

Fengtao Luo

Meng Xu

Jianhua Zhao

Peng Liu

Xianding Sun

Nan Su

Dali Zhang

Weili Fan

Mingyong Liu

Haiyang Huang

Zuqiang Wang

Junlan Huang

Ruobin Zhang

Can Li

Fangfang Li

Zhenhong Ni

Xiaolan Du

Min Jin

Jing Yang

Yangli Xie

Lin Chen

Affiliations

Soon will be listed here.

Abstract

Objective: Scoliosis is a common disease characterized by spinal curvature with variable severities. There is no generally accepted theory about the physical origin of the spinal deformation of scoliosis. The aim of this study was to explore a new hypothesis suggesting that the curvatures in scoliosis may be associated with the imbalance growth between thoracic vertebral column and sternum.

Methods: We undertook a comparative computed tomography (CT) based morphology study of thoracic vertebrae and sternum of patients with adolescent idiopathic scoliosis (AIS) and age-gender matched normal subjects. We further measured the ratios between the lengths of the sternum and thoracic vertebra of mice with deficiency of fibroblast growth factor receptor 3 (FGFR3), which exhibit scoliosis. Three-week-old C57BL/6J mice were used to generate bipedal and sternal growth plate injury model. Radiographs and histological images were obtained to observe the presence of sternal and spinal deformity.

Results: There was a significant correlation between the severities of scoliosis and the ratios of the sternum to thoracic vertebral lengths. We also found that FGFR3 deficient mice showed smaller ratio of the sternum to thoracic vertebra lengths than that of the wild-type mice, which were similar with that of the AIS patients. Surgery-induced injuries of sternal growth plates can accelerate and aggravate the scoliosis in bipedal mice and imbalanced development of anterior and posterior thoracic occurred before the appearance of scoliosis.

Conclusions: Our findings suggest that the imbalanced growth between the thoracic vertebral column and the sternum is an important causative factor for the pathogenesis of scoliosis including AIS.

The Translational Potential Of This Article: Imbalanced growth between the thoracic vertebral column and the sternum is associated with scoliosis. Surgical or rehabilitation intervention for scoliosis should focus on all components involved in the pathogenesis of curvature to obtain better outcome.

Citing Articles

In vivo kinematic study of lumbar center of rotation under different loads.

Li Z, Liu Z, Yang Y, Zhang Z, Meng L, Miao J BMC Musculoskelet Disord. 2025; 26(1):155.

PMID: 39953502 PMC: 11827185. DOI: 10.1186/s12891-025-08410-8.

Patients with Adolescent Idiopathic Scoliosis Have Higher Metabolic Cost during High-Intensity Interval Training.

Lau R, Kwan R, Cheng J, Hui S, Lam T Int J Environ Res Public Health. 2023; 20(3).

PMID: 36767522 PMC: 9915977. DOI: 10.3390/ijerph20032155.

Incidentally Detected Pericardial Defect in a Patient with Pneumothorax as Confirmed on Video-Assisted Thoracoscopic Surgery.

Cho H, Kang E, Kim M, Jeong S, Lee K Taehan Yongsang Uihakhoe Chi. 2022; 82(3):749-755.

PMID: 36238774 PMC: 9432441. DOI: 10.3348/jksr.2020.0057.

Electromyographic Analysis of Paraspinal Muscles of Scoliosis Patients Using Machine Learning Approaches.

Liang R, Yip J, Fan Y, Cheung J, To K Int J Environ Res Public Health. 2022; 19(3).

PMID: 35162203 PMC: 8835103. DOI: 10.3390/ijerph19031177.

Letter to the editor concerning "Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis" by Chen et al., , 2019, https://doi.org/10.1016/j.jot.2018.12.001.

Brink R, Castelein R J Orthop Translat. 2020; 22:142.

PMID: 32440510 PMC: 7231951. DOI: 10.1016/j.jot.2019.07.008.

References

Guo X, Chau W, Chan Y, Cheng J . Relative anterior spinal overgrowth in adolescent idiopathic scoliosis. Results of disproportionate endochondral-membranous bone growth. J Bone Joint Surg Br. 2003; 85(7):1026-31. DOI: 10.1302/0301-620x.85b7.14046. View

Guo X, Chau W, Chan Y, Cheng J, Burwell R, Dangerfield P . Relative anterior spinal overgrowth in adolescent idiopathic scoliosis--result of disproportionate endochondral-membranous bone growth? Summary of an electronic focus group debate of the IBSE. Eur Spine J. 2005; 14(9):862-73. DOI: 10.1007/s00586-005-1002-7. View

Zhu F, Qiu Y, Yeung H, Lee K, Cheng J . Histomorphometric study of the spinal growth plates in idiopathic scoliosis and congenital scoliosis. Pediatr Int. 2006; 48(6):591-8. DOI: 10.1111/j.1442-200X.2006.02277.x. 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

Doi T, Harimaya K, Matsumoto Y, Iwamoto Y . Aortic location and flat chest in scoliosis: a prospective study. Fukuoka Igaku Zasshi. 2011; 102(1):14-9. View

Hong J, Suh S, Park H, Kim Y, Park J, Park S . Correlations of adolescent idiopathic scoliosis and pectus excavatum. J Pediatr Orthop. 2011; 31(8):870-4. DOI: 10.1097/BPO.0b013e31822da7d5. View

Altaf F, Gibson A, Dannawi Z, Noordeen H . Adolescent idiopathic scoliosis. BMJ. 2013; 346:f2508. DOI: 10.1136/bmj.f2508. View

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

Yagi M, Takemitsu M, Machida M . Chest cage angle difference and rotation of main thoracic curve are independent risk factors of postoperative shoulder imbalance in surgically treated patients with adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2013; 38(19):E1209-15. DOI: 10.1097/BRS.0b013e31829e0309. View

10.

Buchan J, Alvarado D, Haller G, Cruchaga C, Harms M, Zhang T . Rare variants in FBN1 and FBN2 are associated with severe adolescent idiopathic scoliosis. Hum Mol Genet. 2014; 23(19):5271-82. PMC: 4159151. DOI: 10.1093/hmg/ddu224. View

11.

Doi T, Matsumoto Y, Tono O, Tarukado K, Harimaya K, Okada S . A shallow chest correlates with the aortic position in the normal spine: features resembling those observed in structural scoliosis. Scoliosis. 2014; 9:14. PMC: 4152277. DOI: 10.1186/1748-7161-9-14. View

12.

Man G, Wai M, Wang W, Jun W, Yim A, Yee Y . A review of pinealectomy-induced melatonin-deficient animal models for the study of etiopathogenesis of adolescent idiopathic scoliosis. Int J Mol Sci. 2014; 15(9):16484-99. PMC: 4200812. DOI: 10.3390/ijms150916484. View

13.

Wu N, Ming X, Xiao J, Wu Z, Chen X, Shinawi M . TBX6 null variants and a common hypomorphic allele in congenital scoliosis. N Engl J Med. 2015; 372(4):341-50. PMC: 4326244. DOI: 10.1056/NEJMoa1406829. View

14.

Sharma S, Londono D, Eckalbar W, Gao X, Zhang D, Mauldin K . A PAX1 enhancer locus is associated with susceptibility to idiopathic scoliosis in females. Nat Commun. 2015; 6:6452. PMC: 4365504. DOI: 10.1038/ncomms7452. View

15.

Gao C, Chen B, Sullivan M, Hui J, Ouellet J, Henderson J . Micro CT Analysis of Spine Architecture in a Mouse Model of Scoliosis. Front Endocrinol (Lausanne). 2015; 6:38. PMC: 4365746. DOI: 10.3389/fendo.2015.00038. View

16.

Kim H . Response to: Evidence-Based of Nonoperative Treatment in Adolescent Idiopathic Scoliosis. Asian Spine J. 2015; 9(2):315. PMC: 4404554. DOI: 10.4184/asj.2015.9.2.315. View

17.

Wu T, Sun X, Zhu Z, Yan H, Guo J, Cheng J . Role of Enhanced Central Leptin Activity in a Scoliosis Model Created in Bipedal Amputated Mice. Spine (Phila Pa 1976). 2015; 40(19):E1041-5. DOI: 10.1097/BRS.0000000000001060. View

18.

Fortin C, Grunstein E, Labelle H, Parent S, Feldman D . Trunk imbalance in adolescent idiopathic scoliosis. Spine J. 2016; 16(6):687-93. DOI: 10.1016/j.spinee.2016.02.033. View

19.

Crijns T, Stadhouder A, Smit T . Restrained Differential Growth: The Initiating Event of Adolescent Idiopathic Scoliosis?. Spine (Phila Pa 1976). 2016; 42(12):E726-E732. DOI: 10.1097/BRS.0000000000001946. View

20.

Zamecnik J, Krskova L, Hacek J, Stetkarova I, Krbec M . Etiopathogenesis of adolescent idiopathic scoliosis: Expression of melatonin receptors 1A/1B, calmodulin and estrogen receptor 2 in deep paravertebral muscles revisited. Mol Med Rep. 2016; 14(6):5719-5724. DOI: 10.3892/mmr.2016.5927. View