Etiology of Idiopathic Scoliosis: Current Trends in Research*

Lowe, Thomas G.; Edgar, Michael; Margulies, Joseph Y.; Miller, Nancy H.; Raso, V.J.; Reinker, Kent A.; Rivard, Charles‐Hilaire

doi:10.2106/00004623-200008000-00014

Cited by 303 publications

(190 citation statements)

References 81 publications

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“…The general incidence of AIS has been reported to range from 2 to 4% [1][2][3][4]. Among the different causes suggested in the literature [5,6], abnormal skeletal growth in AIS has been shown to associate with the development and progression of scoliotic curves [7,8]. In our previous study [9], AIS girls were found to be significantly taller and leaner, and had longer arm span similar to other reports [10][11][12].…”

Section: Introductionsupporting

confidence: 81%

The association of disproportionate skeletal growth and abnormal radius dimension ratio with curve severity in adolescent idiopathic scoliosis

Hung

Lam

et al. 2010

Eur Spine J

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Abnormal anthropometric measurements during the peripubertal growth spurt have been documented in adolescent idiopathic scoliosis (AIS). Magnetic resonance (MR) imaging studies of the spine have suggested a disproportionate endochondral and membranous ossification in AIS. The present study aimed at investigating whether disproportional ossification and skeletal growth occurred in the peripheral bone of AIS patients using the radius as the target bone. Skeletally mature AIS girls with different severity (n = 290) and age-matched control healthy girls (n = 80) were recruited. The anthropometric parameters were recorded. The midshaft of non-dominant radius was scanned with peripheral quantitative computed tomography (pQCT) and the radius diameter was calculated from the cross-sectional area. Radius dimension ratio was derived from the ratio of radius diameter to radius length. The anthropometric parameters were compared between AIS and control with adjustment for age. The radius dimension ratio was further correlated with curve severity in AIS girls using Pearson's correlation test. The analysis showed that the arm span and radius length were slightly longer in AIS girls. The BMI of AIS girls was significantly lower than the controls. The radius dimension ratio in severe AIS girls was significantly lower than the controls and the ratio of AIS girls correlated with the curve severity (r = -0.120; p = 0.039). The abnormal radius dimension ratio supported the presence of systemic growth abnormalities in AIS. Disproportional endochondral-membranous ossification could explain for the observation. The observation of the association of radius dimension ratio with curve severity provides an important potentially clinically measurable parameter for further longitudinal studies on the prognostication of curve progression in AIS.

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Section: Introductionsupporting

confidence: 81%

The association of disproportionate skeletal growth and abnormal radius dimension ratio with curve severity in adolescent idiopathic scoliosis

Hung

Lam

et al. 2010

Eur Spine J

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“…Another prerequisite for the progression of adolescent idiopathic scoliosis is the presence of an adolescent growth spurt (Lowe et al, 2000;Cheung et al, 2008), but it is disputed whether Homo erectus already evolved this distinctive human growth pattern (Smith, 1993;Tardieu, 1998;Smith, 2004;Zihlman et al, 2004;Graves et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Schiess¹,

Boeni²,

Rühli³

et al. 2014

Journal of Human Evolution

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Owing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding skeletal biology of Homo erectus. Nevertheless, since Latimer and Ohman (2001, Axial dysplasia in Homo erectus. J Hum Evol 40:A12) reported on asymmetries and distortions of Nariokotome boy's axial skeleton suggesting adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as reference for Homo erectus. Recently, however, the presence of skeletal dysplasia has been refuted. Here, we present a morphologic and morphometric reanalysis of the assertion of idiopathic scoliosis. We demonstrate that unarticulated vertebral columns of non-scoliotic and scoliotic individuals can be distinguished based on the lateral deviation of the spinous process, lateral and sagittal wedging, vertebral body torsion, pedicle thickness asymmetry and asymmetry of the superior and inferior articular facet area. A principal component analysis of the overall asymmetry of all seven vertebral shape variables groups KNM-WT 15000 within non-scoliotic modern humans. An anomaly of vertebrae T1-T2 is compatible with a short left convex curve at the uppermost thoracic region, possibly due to injury or local growth dysbalance. Asymmetries of the facet joints L3-L5 suggest a local right convex curve in the lower lumbar region that probably resulted from juvenile traumatic disc herniation. This pattern is incompatible with adolescent idiopathic scoliosis or other types of scoliosis, including congenital, neuromuscular or syndromic scoliosis. It is, however, consistent with a recent reanalysis of the rib cage that did not reveal any asymmetry. Except for these possibly trauma-related anomalies, the Nariokotome boy fossil therefore seems to belong to a normal Homo erectus youth without evidence for adolescent idiopathic scoliosis or other severe pathologies of the axial skeleton. AbstractOwing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding skeletal biology of Homo erectus. Nevertheless, since Latimer and Ohman (2001, Axial dysplasia in Homo erectus. J Hum Evol 40:A12) reported on asymmetries and distortions of Nariokotome boy's axial skeleton suggesting adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as reference for Homo erectus. Recently, however, the presence of skeletal dysplasia has been refuted. Here, we present a morphologic and morphometric reanalysis of the assertion of idiopathic scoliosis. We demonstrate that unarticulated vertebral columns of non-scoliotic and scoliotic individuals can be distinguished based on the lateral deviation of the spinous process, lateral and sagittal wedging, vertebral body torsion, pedicle thickness asymmetry and asymmetry of the superior and inferior articular facet area. A principal component analysis of the overall asymmetry of all seven vertebral shap...

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“…proprioceptive systems, biomechanical factors, uncoupled neuro-osseous growth and dissociation between the timing of skeletal and CNS maturation [1][2][3][4][5][6][7]. There is considerable difficulty in distinguishing the primary underlying pathogenetic factor(s) that cause deformity from the secondary changes that arise secondary to the deformity.…”

Section: Introductionmentioning

confidence: 99%

Selective estrogen receptor modulation prevents scoliotic curve progression: radiologic and histomorphometric study on a bipedal C57Bl6 mice model

et al. 2013

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Purpose Previous work has suggested that progression of experimental scoliotic curves in pinealectomized chicken and bipedal C57BL6 mice models may be prevented and reversed with Tamoxifen treatment. Raloxifene is another Selective Estrogen Receptor Modulator (SERM) with estrogen agonist effects on bone and increases bone density but with fewer side effects on humans. To investigate whether scoliosis progression in bipedal C57Bl6 mice model could be prevented with SERM treatment and the mechanisms associated with this effect. Methods Eighty C57BL6 mice were rendered bipedal and divided into Tamoxifen (TMX), Raloxifene (RLX) and control groups. TMX and RLX groups received orally administered TMX and RLX for 40 weeks. Anteroposterior X-ray imaging and histomorphometric analysis (at 20th and 40th weeks) were performed. Results At 20th week, TMX and RLX groups displayed higher rates (p = 0.033, p = 0.029) and larger curve magnitudes (p = 0.018). At 40th week, curve rates were similar between the groups but the curve magnitudes in TMX and RLX groups were smaller (p = 0.001). Histomorphometry revealed that treated animals had higher trabecular density (p = 0.04), lower total intervertebral disc (p = 0.038) and growth plate volumes (p = 0.005) and smaller vertebral bodies (p = 0.016). Conclusions Treatment with TMX or RLX did not reduce the incidence of scoliosis but decreased the curve magnitudes at 40 weeks. The underlying mechanism associated with the decrease in curve magnitudes may be the early maturation of growth plates, thereby possible deceleration of the growth rate of the vertebral column and increase in bone density. RLX is as effective as TMX in preventing the progression of scoliotic curves in melatonin deficient bipedal mice.

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Etiology of Idiopathic Scoliosis: Current Trends in Research*

Cited by 303 publications

References 81 publications

The association of disproportionate skeletal growth and abnormal radius dimension ratio with curve severity in adolescent idiopathic scoliosis

The association of disproportionate skeletal growth and abnormal radius dimension ratio with curve severity in adolescent idiopathic scoliosis

Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Selective estrogen receptor modulation prevents scoliotic curve progression: radiologic and histomorphometric study on a bipedal C57Bl6 mice model

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