Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 5/2011

01-05-2011 | Symposium: Early Onset Scoliosis

Neurocentral Synchondrosis Screws to Create and Correct Experimental Deformity: A Pilot Study

Authors: Hong Zhang, MD, Daniel J. Sucato, MD, MS

Published in: Clinical Orthopaedics and Related Research® | Issue 5/2011

Login to get access

Abstract

Background

Unilateral pedicle screw epiphysiodesis of the neurocentral synchondrosis (NCS) can produce asymmetric growth of the synchondrosis to create scoliosis in an immature animal model.

Questions/purposes

We asked whether a preexisting experimentally created scoliosis could be limited and corrected by modulating the growth of the faster-growing NCS by a similar method.

Methods

Nine 1-month-old pigs were assigned to each of three groups: (1) a sham group in which three animals received a sham operation but without a pedicle screw fixation; (2) an experimental group with double right pedicle screws placed across the NCS from T7 to T14 (scoliosis-untreated); and (3) an experimental group treated in the same way except a second set of double pedicle screws was placed in the left pedicles 6 weeks after the screws were placed on the right (scoliosis-treated). All animals were euthanized at 17 weeks, and radiographs and axial CT images of the spine were obtained.

Results

A scoliotic curve was not seen in any of the animals in the sham group, in three of three in the scoliosis-untreated group with an average of 34°, and in three of three in the scoliosis-treated group with an average of 20°. In comparison to the scoliosis-untreated group, the second set of pedicle screws produced a 41% correction of the scoliosis.

Conclusions

We found the pedicle screw inhibited the overgrowth of the NCS to prevent further curve progression and obtained some correction of the deformity. The NCS screw epiphysiodesis can create and reverse scoliosis in an immature pig model.
Literature
1.
go back to reference Beguiristain JL, Salis JD, Canadell J. Experimental scoliosis by epiphysiodesis in pigs. Int Orthop. 1980;3:317–321.PubMedCrossRef Beguiristain JL, Salis JD, Canadell J. Experimental scoliosis by epiphysiodesis in pigs. Int Orthop. 1980;3:317–321.PubMedCrossRef
2.
go back to reference Cil A, Yazici M, Daglioglu K, Aydingoz U, Alanay A, Acaroglu RE, Gulsen M, Surat A. The effect of pedicle screw placement with or without application of compression across the neurocentral cartilage on the morphology of the spinal canal and pedicle in immature pigs. Spine. 2005;30:1287–1293.PubMedCrossRef Cil A, Yazici M, Daglioglu K, Aydingoz U, Alanay A, Acaroglu RE, Gulsen M, Surat A. The effect of pedicle screw placement with or without application of compression across the neurocentral cartilage on the morphology of the spinal canal and pedicle in immature pigs. Spine. 2005;30:1287–1293.PubMedCrossRef
3.
go back to reference Dimeglio A. Growth of the spine before age 5 years. J Pediatr Orthop B. 1993;1:102–107. Dimeglio A. Growth of the spine before age 5 years. J Pediatr Orthop B. 1993;1:102–107.
5.
go back to reference Huynh AM, Aubin CE, Rajwani T, Bagnall KM, Villemure I. Pedicle growth asymmetry as a cause of adolescent idiopathic scoliosis: a biomechanical study. Eur Spine J. 2007;16:523–529.PubMedCrossRef Huynh AM, Aubin CE, Rajwani T, Bagnall KM, Villemure I. Pedicle growth asymmetry as a cause of adolescent idiopathic scoliosis: a biomechanical study. Eur Spine J. 2007;16:523–529.PubMedCrossRef
6.
go back to reference Maat G, Matricali B, Meerten E. Postnatal development and structure of the neurocentral junction. Spine. 1996;21:661–666.PubMedCrossRef Maat G, Matricali B, Meerten E. Postnatal development and structure of the neurocentral junction. Spine. 1996;21:661–666.PubMedCrossRef
7.
go back to reference Michelsson JE. The development of spinal deformity in experimental scoliosis. Acta Orthop Scand Suppl. 1965;Suppl 81:1–91. Michelsson JE. The development of spinal deformity in experimental scoliosis. Acta Orthop Scand Suppl. 1965;Suppl 81:1–91.
8.
go back to reference Ottander HG. Experimental progressive scoliosis in a pig. Acta Orthop Scand. 1963;33:91–97.CrossRef Ottander HG. Experimental progressive scoliosis in a pig. Acta Orthop Scand. 1963;33:91–97.CrossRef
9.
go back to reference Piggott H. Growth modification in the treatment of scoliosis. Orthopedics. 1987;10:945–952.PubMed Piggott H. Growth modification in the treatment of scoliosis. Orthopedics. 1987;10:945–952.PubMed
10.
go back to reference Rajwani T, Bagnall KM, Lambert R, Videman T, Kautz J, Moreau M, Mahood J, Raso V, Bhargava R. Using magnetic resonance imaging of characterize pedicle asymmetry in both normal patients and patients with adolescent idiopathic scoliosis. Spine. 2004;29:E145–152.PubMedCrossRef Rajwani T, Bagnall KM, Lambert R, Videman T, Kautz J, Moreau M, Mahood J, Raso V, Bhargava R. Using magnetic resonance imaging of characterize pedicle asymmetry in both normal patients and patients with adolescent idiopathic scoliosis. Spine. 2004;29:E145–152.PubMedCrossRef
11.
go back to reference Rajwani T, Bhargava R, Moreau M, Mahood J, Raso VJ, Jiang H, Bagnall KM. MRI characteristics of the neurocentral synchondrosis. Pediatr Radiol. 2002;32:811–816.PubMedCrossRef Rajwani T, Bhargava R, Moreau M, Mahood J, Raso VJ, Jiang H, Bagnall KM. MRI characteristics of the neurocentral synchondrosis. Pediatr Radiol. 2002;32:811–816.PubMedCrossRef
12.
go back to reference Roaf R. Rotation movement of the spine with special reference to scoliosis. J Bone Joint Surg Br. 1958;40:312–331.PubMed Roaf R. Rotation movement of the spine with special reference to scoliosis. J Bone Joint Surg Br. 1958;40:312–331.PubMed
13.
go back to reference Roaf R. Vertebral growth and its mechanical control. J Bone Joint Surg Br. 1960;42:40–59.PubMed Roaf R. Vertebral growth and its mechanical control. J Bone Joint Surg Br. 1960;42:40–59.PubMed
14.
go back to reference Sarwark J, Aubin CE. Growth considerations of the immature spine. J Bone Joint Surg Am. 2007;89(Suppl 1):8–13.PubMedCrossRef Sarwark J, Aubin CE. Growth considerations of the immature spine. J Bone Joint Surg Am. 2007;89(Suppl 1):8–13.PubMedCrossRef
15.
go back to reference Taylor JR. Scoliosis and growth: patterns of asymmetric in normal vertebral growth. Acta Orthop Scand. 1983;54:596–602.PubMedCrossRef Taylor JR. Scoliosis and growth: patterns of asymmetric in normal vertebral growth. Acta Orthop Scand. 1983;54:596–602.PubMedCrossRef
16.
go back to reference Vital JM, Beguiristain JL, Algara C, Villas C, Lavignolle B, Grenier N, Senegas J. The neurocentral vertebral cartilage: anatomy, physiology, and physiology, and physiopathology. Surg Radiol Anat. 1989;11:323–328.PubMedCrossRef Vital JM, Beguiristain JL, Algara C, Villas C, Lavignolle B, Grenier N, Senegas J. The neurocentral vertebral cartilage: anatomy, physiology, and physiology, and physiopathology. Surg Radiol Anat. 1989;11:323–328.PubMedCrossRef
17.
go back to reference Yamazaki A, Mason DE, Caro PA. Age of closure of the neurocentral cartilage in the thoracic spine. J Pediatr Orthop. 1998;18:168–172.PubMedCrossRef Yamazaki A, Mason DE, Caro PA. Age of closure of the neurocentral cartilage in the thoracic spine. J Pediatr Orthop. 1998;18:168–172.PubMedCrossRef
18.
go back to reference Zhang H, Sucato DJ. Unilateral pedicle screw epiphysiodesis of the neurocentral synchondrosis. Production of idiopathic-like scoliosis in an immature animal model. J Bone Joint Surg Am. 2008;90:2460–2469.PubMedCrossRef Zhang H, Sucato DJ. Unilateral pedicle screw epiphysiodesis of the neurocentral synchondrosis. Production of idiopathic-like scoliosis in an immature animal model. J Bone Joint Surg Am. 2008;90:2460–2469.PubMedCrossRef
19.
go back to reference Zhang H, Sucato DJ, Nurenberg P, McClung A. Morphometric analysis of neurocentral synchondrosis using magnetic resonance imaging in the normal skeletally immature spine. Spine. 2010;35:76–82.PubMedCrossRef Zhang H, Sucato DJ, Nurenberg P, McClung A. Morphometric analysis of neurocentral synchondrosis using magnetic resonance imaging in the normal skeletally immature spine. Spine. 2010;35:76–82.PubMedCrossRef
20.
go back to reference Zindrick MR, Knight GW, Sartori MJ, Mark J, Carnevale TJ, Patwardhan AG, Lorenz MA. Pedicle morphology of the immature thoracolumbar spine. Spine. 2000;25:2726–2735.PubMedCrossRef Zindrick MR, Knight GW, Sartori MJ, Mark J, Carnevale TJ, Patwardhan AG, Lorenz MA. Pedicle morphology of the immature thoracolumbar spine. Spine. 2000;25:2726–2735.PubMedCrossRef
Metadata
Title
Neurocentral Synchondrosis Screws to Create and Correct Experimental Deformity: A Pilot Study
Authors
Hong Zhang, MD
Daniel J. Sucato, MD, MS
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 5/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-010-1587-y

Other articles of this Issue 5/2011

Clinical Orthopaedics and Related Research® 5/2011 Go to the issue

Symposium: Early Onset Scoliosis

Early Onset Scoliosis: Editorial Comment