Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2016 | Research article

Plasticity of vertebral wedge deformities in skeletally immature patients with adolescent idiopathic scoliosis after posterior corrective surgery

Authors: Takahiro Makino, Takashi Kaito, Yusuke Sakai, Shota Takenaka, Kazuomi Sugamoto, Hideki Yoshikawa

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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.

Horne JP, Flannery R, Usman S. Adolescent idiopathic scoliosis: diagnosis and management. Am Fam Physician. 2009;89:193–8.

Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA. Adolescent idiopathic scoliosis. Lancet. 2008;371:1527–37. doi:10.1016/S0140-6736(08)60658-3.CrossRefPubMed

Parent S, Labelle H, Skalli W, de Guise J. Vertebral wedging characteristic changes in scoliotic spines. Spine (Phila Pa 1976). 2004;29:E455–62.CrossRef

Schlösser TP, van Stralen M, Brink RC, Chu WC, Lam TP, Vincken KL, et al. Three-dimensional characterization of torsion and asymmetry of the intervertebral discs versus vertebral bodies in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2014;39:E1159–66. doi:10.1097/BRS.0000000000000467.CrossRef

Scherrer SA, Begon M, Leardini A, Coillard C, Rivard CH, Allard P. Three-dimensional vertebral wedging in mild and moderate adolescent idiopathic scoliosis. PLoS One. 2013;8:e71504. doi:10.1371/journal.pone.0071504.CrossRefPubMedPubMedCentral

Begon M, Scherrer SA, Coillard C, Rivard CH, Allard P. Three-dimensional vertebral wedging and pelvic asymmetries in the early stages of adolescent idiopathic scoliosis. Spine J. 2015;15:477–86. doi:10.1016/j.spinee.2014.10.004.CrossRefPubMed

Sarwark J, Aubin CE. Growth considerations of the immature spine. J Bone Joint Surg Am. 2007;89 Suppl 1:8–13.PubMed

Lenke LG, Betz RR, Harms J, Bridwell KH, Clements DH, Lowe TG, et al. Adolescent idiopathic scoliosis: a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg Am. 2001;83-A:1169–81.CrossRefPubMed

Fujimori T, Iwasaki M, Nagamoto Y, Ishii T, Sakaura H, Kashii M, et al. Three-dimensional measurement of growth of ossification of the posterior longitudinal ligament. J Neurosurg Spine. 2012;16:289–95. doi:10.3171/2011.11.SPINE11502.CrossRefPubMed

10.

Matsuo Y, Kaito T, Iwasaki M, Sugiura T, Fujimori T, Nagamoto Y, et al. 3D morphometric analysis of laminae and facet joints in patients with degenerative spondylolisthesis. Mod Rheumatol. 2015;25:756–60. doi:10.3109/14397595.2015.1008673.CrossRefPubMed

11.

Stokes IA. Mechanical effects on skeletal growth. J Musculoskelet Neuronal Interact. 2002;2:277–80.PubMed

12.

Stokes IA, Spence H, Aronsson DD, Kilmer N. Mechanical modulation of vertebral body growth. Implications for scoliosis progression. Spine (Phila Pa 1976). 1996;21:1162–7.CrossRef

13.

Meir AR, Fairbank JC, Jones DA, McNally DS, Urban JP. High pressures and asymmetrical stresses in the scoliotic disc in the absence of muscle loading. Scoliosis. 2007;2:4.CrossRefPubMedPubMedCentral

14.

Meir A, McNally DS, Fairbank JC, Jones D, Urban JP. The internal pressure and stress environment of the scoliotic intervertebral disc--a review. Proc Inst Mech Eng H. 2008;222:209–19.CrossRefPubMed

15.

Modi HN, Suh SW, Song HR, Yang JH, Kim HJ, Modi CH. 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. doi:10.1186/1748-7161-3-11.CrossRefPubMedPubMedCentral

16.

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.CrossRefPubMedPubMedCentral

17.

Kou I, Takahashi Y, Johnson TA, Takahashi A, Guo L, Dai J, et al. Genetic variants in GPR126 are associated with adolescent idiopathic scoliosis. Nat Genet. 2013;45:676–9. doi:10.1038/ng.2639.CrossRefPubMed

18.

Ogura Y, Kou I, Miura S, Takahashi A, Xu L, Takeda K, et al. A functional SNP in BNC2 is associated with adolescent idiopathic scoliosis. Am J Hum Genet. 2015;97:337–42. doi:10.1016/j.ajhg.2015.06.012.CrossRefPubMedPubMedCentral

19.

Liljenqvist UR, Allkemper T, Hackenberg L, Link TM, Steinbeck J, Halm HF. Analysis of vertebral morphology in idiopathic scoliosis with use of magnetic resonance imaging and multiplanar reconstruction. J Bone Joint Surg Am. 2002;84-A:359–68.CrossRefPubMed

20.

Kuklo TR, Potter BK, Lenke LG. Vertebral rotation and thoracic torsion in adolescent idiopathic scoliosis: what is the best radiographic correlate? J Spinal Disord Tech. 2005;18:139–47.CrossRefPubMed

21.

Hayashi K, Upasani VV, Pawelek JB, Aubin CE, Labelle H, Lenke LG, et al. Three-dimensional analysis of thoracic apical sagittal alignment in adolescent idiopathic scoliosis. Spine (Phila Pa 1976). 2009;34:792–7. doi:10.1097/BRS.0b013e31818e2c36.CrossRef

22.

Newton PO, Fujimori T, Doan J, Reighard FG, Bastrom TP, Misaghi A. Defining the “Three-Dimensional Sagittal Plane” in thoracic adolescent idiopathic scoliosis. J Bone Joint Surg Am. 2015;97:1694–701. doi:10.2106/JBJS.O.00148.CrossRefPubMed

23.

Hattori T, Sakaura H, Iwasaki M, Nagamoto Y, Yoshikawa H, Sugamoto K. In vivo three-dimensional segmental analysis of adolescent idiopathic scoliosis. Eur Spine J. 2011;20:1745–50. doi:10.1007/s00586-011-1869-4.CrossRefPubMedPubMedCentral

Title: Plasticity of vertebral wedge deformities in skeletally immature patients with adolescent idiopathic scoliosis after posterior corrective surgery
Authors: Takahiro Makino
Takashi Kaito
Yusuke Sakai
Shota Takenaka
Kazuomi Sugamoto
Hideki Yoshikawa
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-016-1287-1

ACC 2024 Congress

Springer Medicine

Plasticity of vertebral wedge deformities in skeletally immature patients with adolescent idiopathic scoliosis after posterior corrective surgery

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Risk factors of adjacent vertebral collapse after percutaneous vertebroplasty for osteoporotic vertebral fracture in postmenopausal women

No clear benefit or drawback to the use of closed drainage after primary total knee arthroplasty: a systematic review and meta-analysis

Eye movements in patients with Whiplash Associated Disorders: a systematic review

Influence of ankle fracture surgery on glycemic control in patients with diabetes

Intra-articular injection of photo-activated platelet-rich plasma in patients with knee osteoarthritis: a double-blind, randomized controlled pilot study

Local pamidronate influences fracture healing in a rodent femur fracture model: an experimental study