Asynchronous neuro-osseous growth in adolescent idiopathic scoliosis—MRI-based research

Abstract

Adolescent idiopathic scoliosis (AIS) is a common worldwide problem and has been treated for many decades; however, there still remain uncertain areas about this disorder. Its involvement and impact on different parts of the human body remain underestimated due to lack of technology in imaging for objective assessment in the past. The advances in imaging technique and image analysis technology have provided a novel approach for the understanding of the phenotypic presentation of neuro-osseous changes in AIS patients as compared with normal controls. This review is the summary of morphological assessment of the skeletal and nervous systems in girls with AIS based on MRI. Girls with AIS are found to have morphological differences in multiple areas including the vertebral column, spinal cord, skull and brain when compared with age- and sex-matched normal controls. Taken together, the abnormalities in the skeletal system and nervous system of AIS are likely to be inter-related and reflect a systemic process of asynchronous neuro-osseous growth. The current knowledge about the anatomical changes in AIS has important implications with respect to the understanding of fundamental pathomechanical processes involved in the evolution of the scoliotic deformity.

Anatomical Origin of Abnormal Somatosensory-Evoked Potential (SEP) in Adolescent Idiopathic Scoliosis With Different Curve Severity and Correlation With Cerebellar Tonsillar Level Determined by MRI

“…The findings of the current study also provide neurophysiological functional proof to further consolidate our previous observation about the relative tethering of spinal cord and relative spinal overgrowth in AIS, and the increased incidence of low-lying cerebellar tonsils, 29 impaired postural balance and gait, 13,14,[33][34][35][36][37] and the DTI evidence of decreased White Matter integrity within the brain stem and spinal cord in AIS. 20 Our finding might shed light on the pathoanatomical origin of abnormal SEP in AIS patients, particularly in patients with Cobb angle over 40 degrees.…”

Variation in Anisotropy and Diffusivity along the Medulla Oblongata and the Whole Spinal Cord in Adolescent Idiopathic Scoliosis: A Pilot Study Using Diffusion Tensor Imaging

“…[4][5][6] Furthermore in a number of MR imaging studies, the observable changes in morphologic shape and position of the cord, 7 mismatch in lengthening between the cord and vertebral column, 8 and increased incidence of low-lying cerebellar tonsils 9 have led to the postulation of the presence of subclinical tethering of the spinal cord in AIS. 10 The proposed disturbed spinal cord function in AIS was further supported by the clinical observation of abnormal somatosensory function, which has been widely reported in this group. Prolonged latency or absent waveforms in posterior tibial nerve somatosensory evoked potentials (SEPs) were reported in 12%-61% of patients with scoliosis in different series.…”

“…29,30 MR imaging has long been used for assessment of the brain and spinal cord in AIS in view of its high resolution and excellent soft-tissue contrast. 10 Geissele et al 31 following the curve of scoliosis on T2-weighted MR imaging. In previous works, 7,8,30 significantly reduced ratios of spinal cord to vertebral column were found in patients with AIS by using multiplanar reformatted MR imaging.…”

T1-weighted MR imaging of bone marrow pattern in children with adolescent idiopathic scoliosis: A preliminary study

“…MR imaging research of patients with scoliosis has concentrated on morphometric measurements of skull and spine, assessment of T2-weighted changes in the intervertebral discs, evaluation of the spinal cord, cranio-cervical junction and brain morphometrics. 6 Our search of the literature did not find any description of bone marrow conversion pattern in these children.…”