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Open Access 01-12-2022 | Scoliosis | Research article

Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis

Authors: Kwong Hang Yeung, Gene Chi Wai Man, Min Deng, Tsz Ping Lam, Jack Chun Yiu Cheng, Ka Chi Chan, Winnie Chiu Wing Chu

Published in: BMC Musculoskeletal Disorders | Issue 1/2022

Abstract

Background

Our previous studies found disproportionate anteroposterior vertebral size is associated with severity of the scoliotic curves in adolescent idiopathic scoliosis (AIS) patients. Subsequent studies showed wedging of vertebral bodies (VB) had less contribution than intervertebral discs (IVD) to the anterior–posterior vertebral column length discrepancy in severe-AIS. However, the exact morphological changes of IVD were not clearly defined. This study aimed to evaluate the morphological and pathological changes of IVD and VB in AIS girls and healthy female controls.

Methods

This study included 33 age-matched female controls and 76 AIS girls with a right-sided thoracic curvature. Wedge angle, height ratio and distance ratio of VB and IVD were measured on the best midline coronal and sagittal planes from reformatted MRI spine. Volumes of VB, IVD and nucleus pulposus (NP) were also evaluated on volumetric images. One-way ANOVA with Bonferroni correction and Pearson correlation tests were used.

Results

There was significant difference in wedge angle and height ratio of VB and IVD between AIS and controls. In severe-AIS, the position of NP was significantly shifted to the convexity when compared with non-severe AIS and controls. Whereas, the volume of IVD and NP in severe-AIS was found to be significantly smaller. In addition, Cobb angle was significantly correlated with wedge angle and height ratio, and inversely correlated with the volume of NP.

Conclusions

In addition to wedging of VB and IVD, there was significantly reduced volume of IVD and NP in AIS patients with severe curve, insinuating the mechanical effect of scoliosis leads to a compression on both IVD and NP before significant disc desiccation occurs. We postulate that the compression of IVD and NP can contribute to curve progression in severe-AIS, these patients are more prone to disc degeneration in adulthood if no operative treatment is offered. Further longitudinal study on these parameters is still warranted.

Cheng JC, Castelein RM, Chu WC, et al. Adolescent idiopathic scoliosis. Nat Rev Dis Primer. 2015;1:15030. https://doi.org/10.1038/nrdp.2015.30.CrossRef

Siu King Cheung C, Tak Keung Lee W, Kit Tse Y, et al. Abnormal peri-pubertal anthropometric measurements and growth pattern in adolescent idiopathic scoliosis: a study of 598 patients. Spine. 2003;28:2152–7. https://doi.org/10.1097/01.BRS.0000084265.15201.D5.CrossRefPubMed

Guo X, Chau WW, Chan YL, Cheng JCY. Relative anterior spinal overgrowth in adolescent idiopathic scoliosis. Results of disproportionate endochondral-membranous bone growth. J Bone Joint Surg Br. 2003;85:1026–31. https://doi.org/10.1302/0301-620x.85b7.14046.CrossRefPubMed

Cheng JC, Guo X, Sher AH, et al. Correlation between curve severity, somatosensory evoked potentials, and magnetic resonance imaging in adolescent idiopathic scoliosis. Spine. 1999;24:1679–84. https://doi.org/10.1097/00007632-199908150-00009.CrossRefPubMed

Cheng JC-Y, Chau W-W, Guo X, Chan Y-L. Redefining the magnetic resonance imaging reference level for the cerebellar tonsil: a study of 170 adolescents with normal versus idiopathic scoliosis. Spine. 2003;28:815–8.PubMed

Chu WCW, Lam WWM, Chan Y-L, et al. Relative shortening and functional tethering of spinal cord in adolescent idiopathic scoliosis?: study with multiplanar reformat magnetic resonance imaging and somatosensory evoked potential. Spine. 2006;31:E19-25. https://doi.org/10.1097/01.brs.0000193892.20764.51.CrossRefPubMed

Chu WCW, Man GCW, Lam WWM, et al. Morphological and functional electrophysiological evidence of relative spinal cord tethering in adolescent idiopathic scoliosis. Spine. 2008;33:673–80. https://doi.org/10.1097/BRS.0b013e318166aa58.CrossRefPubMed

Yeung KH, Man GCW, Shi L, et al. Magnetic Resonance Imaging-Based Morphological Change of Paraspinal Muscles in Girls With Adolescent Idiopathic Scoliosis. Spine. 2019;44:1356–63. https://doi.org/10.1097/BRS.0000000000003078.CrossRefPubMed

Schlösser TPC, van Stralen M, Brink RC, et al. Three-dimensional characterization of torsion and asymmetry of the intervertebral discs versus vertebral bodies in adolescent idiopathic scoliosis. Spine. 2014;39:E1159-1166. https://doi.org/10.1097/BRS.0000000000000467.CrossRefPubMed

10.

Brink RC, Schlösser TPC, Colo D, et al. Anterior Spinal Overgrowth Is the Result of the Scoliotic Mechanism and Is Located in the Disc. Spine. 2017;42:818–22. https://doi.org/10.1097/BRS.0000000000001919.CrossRefPubMed

11.

Akeson WH, Woo SL, Taylor TK, et al (1977) Biomechanics and biochemistry of the intervertebral disks: the need for correlation studies. Clin Orthop 133–140. https://doi.org/10.1097/00003086-197711000-00015

12.

Oegema TR. Biochemistry of the intervertebral disc. Clin Sports Med. 1993;12:419–39.CrossRef

13.

Taylor TK, Ghosh P, Bushell GR (1981) The contribution of the intervertebral disk to the scoliotic deformity. Clin Orthop 79–90

14.

Will RE, Stokes IA, Qiu X, et al. Cobb angle progression in adolescent scoliosis begins at the intervertebral disc. Spine. 2009;34:2782–6. https://doi.org/10.1097/BRS.0b013e3181c11853.CrossRefPubMedPubMedCentral

15.

Stokes IA, Aronsson DD. Disc and vertebral wedging in patients with progressive scoliosis. J Spinal Disord. 2001;14:317–22. https://doi.org/10.1097/00002517-200108000-00006.CrossRefPubMed

16.

Stokes IAF, Burwell RG, Dangerfield PH, IBSE,. Biomechanical spinal growth modulation and progressive adolescent scoliosis–a test of the “vicious cycle” pathogenetic hypothesis: summary of an electronic focus group debate of the IBSE. Scoliosis. 2006;1:16. https://doi.org/10.1186/1748-7161-1-16.CrossRefPubMedPubMedCentral

17.

Nakhaee K, Golpaygani AT, Abedi R. Relationship Between Intervertebral Disc Morphology and Adolescent Idiopathic Scoliosis. J Clin Eng. 2019;44:174–9. https://doi.org/10.1097/JCE.0000000000000360.CrossRef

18.

Ponrartana S, Fisher CL, Aggabao PC, et al. Small vertebral cross-sectional area and tall intervertebral disc in adolescent idiopathic scoliosis. Pediatr Radiol. 2016;46:1424–9. https://doi.org/10.1007/s00247-016-3633-8.CrossRefPubMed

19.

Yeung KH, Man G, Hung A, et al. Morphological changes of intervertebral disc in relation with curve severity of patients with Adolescent Idiopathic Scoliosis - a T2-weighted MRI study. Stud Health Technol Inform. 2021;280:37–9. https://doi.org/10.3233/SHTI210431.CrossRefPubMed

20.

Violas P, Estivalezes E, Briot J, et al. Quantification of Intervertebral Disc Volume Properties Below Spine Fusion, Using Magnetic Resonance Imaging, in Adolescent Idiopathic Scoliosis Surgery. Spine. 2007;32:E405–12. https://doi.org/10.1097/BRS.0b013e318074d69f.CrossRefPubMed

21.

Kwok AWL, Wang Y-XJ, Griffith JF, et al. Morphological changes of lumbar vertebral bodies and intervertebral discs associated with decrease in bone mineral density of the spine: a cross-sectional study in elderly subjects. Spine. 2012;37:E1415-1421. https://doi.org/10.1097/BRS.0b013e31826f561e.CrossRefPubMed

22.

Modi HN, Suh SW, Song H-R, et al. 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. https://doi.org/10.1186/1748-7161-3-11.CrossRefPubMedPubMedCentral

23.

Yushkevich PA, Piven J, Hazlett HC, et al. User-guided 3D active contour segmentation of anatomical structures: significantly improved efficiency and reliability. Neuroimage. 2006;31:1116–28. https://doi.org/10.1016/j.neuroimage.2006.01.015.CrossRefPubMed

24.

Périé D, Curnier D, de Gauzy JS. Correlation between nucleus zone migration within scoliotic intervertebral discs and mechanical properties distribution within scoliotic vertebrae. Magn Reson Imaging. 2003;21:949–53. https://doi.org/10.1016/s0730-725x(03)00216-9.CrossRefPubMed

25.

Périé D, Sales de Gauzy J, Curnier D, Hobatho MC. Intervertebral disc modeling using a MRI method: migration of the nucleus zone within scoliotic intervertebral discs. Magn Reson Imaging. 2001;19:1245–8. https://doi.org/10.1016/s0730-725x(01)00452-0.CrossRefPubMed

26.

Violas P, Estivalèzes E, Pédrono A, et al. A method to investigate intervertebral disc morphology from MRI in early idiopathic scoliosis: a preliminary evaluation in a group of 14 patients. Magn Reson Imaging. 2005;23:475–9. https://doi.org/10.1016/j.mri.2004.12.004.CrossRefPubMed

27.

Zhao F, Pollintine P, Hole BD, et al. Discogenic origins of spinal instability. Spine. 2005;30:2621–30. https://doi.org/10.1097/01.brs.0000188203.71182.c0.CrossRefPubMed

28.

Hristova GI, Jarzem P, Ouellet JA, et al. Calcification in human intervertebral disc degeneration and scoliosis. J Orthop Res Off Publ Orthop Res Soc. 2011;29:1888–95. https://doi.org/10.1002/jor.21456.CrossRef

29.

Yu J, Fairbank JCT, Roberts S, Urban JPG. The elastic fiber network of the anulus fibrosus of the normal and scoliotic human intervertebral disc. Spine. 2005;30:1815–20. https://doi.org/10.1097/01.brs.0000173899.97415.5b.CrossRefPubMed

30.

Karavidas N. Bracing In The Treatment Of Adolescent Idiopathic Scoliosis: Evidence To Date. Adolesc Health Med Ther. 2019;10:153–72. https://doi.org/10.2147/AHMT.S190565.CrossRefPubMedPubMedCentral

Title: Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis
Authors: Kwong Hang Yeung
Gene Chi Wai Man
Min Deng
Tsz Ping Lam
Jack Chun Yiu Cheng
Ka Chi Chan
Winnie Chiu Wing Chu
Publication date: 01-12-2022
Publisher: BioMed Central
Keywords: Scoliosis
Adolescent Idiopathic Scoliosis
Published in: BMC Musculoskeletal Disorders / Issue 1/2022
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-022-05561-w

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Springer Medicine

Morphological changes of Intervertebral Disc detectable by T2-weighted MRI and its correlation with curve severity in Adolescent Idiopathic Scoliosis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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