Low bone mineral status in adolescent idiopathic scoliosis

Abstract

Adolescent idiopathic scoliosis (AIS) is a pathological entity of unknown etiology. The causes of osteoporosis or osteopenia in AIS remain undetermined. Whether poor bone quality is an etiologic factor remains controversial. To determine the correlation between low bone mineral status and AIS, a review of literature was performed. After a literature search from 1966 to June 2007 (using Medline, EMBASE, Cochrane DSR, ACP Journal Club, DARE, CCTR, CINAHL and hand searches of references) for studies regarding low bone mineral status and AIS, 20 studies meeting the inclusion criteria were reviewed in terms of the appropriateness of valuation technique, the validity of descriptive system, the number and type of respondents, and overall quality of the studies. Nearly all investigations demonstrated that low bone mineral density (BMD) was a generalized phenomenon and a systematic disorder in AIS. The prevalence of AIS with osteoporosis is approximately 20-38%. The follow-up studies indicated that osteopenia in patients with AIS may be a persistent phenomenon. BMD could be affected by the mechanical loading and lower bone mineral mass is always associated with lower bone strength. The spinal architecture associated with the osteopenia may aggravate the spinal deformity. However, with regard to the concave and convex femoral neck BMD values, and the correlation of BMD to scoliosis parameters, the results remain inconsistent. Bracing may not result in permanent loss of bone mineral mass. The effect of the eccentric tension-compression environments on BMD, the correlation of BMD with scoliosis parameters and the effect of bracing on BMD should be investigated further in prospective, randomized and longitudinal follow-up studies.

XbaI and PvuII Polymorphisms of Estrogen Receptor 1 Gene in Females with Idiopathic Scoliosis: No Association with Occurrence or Clinical Form

“…SNPs association with bone mineral density (BMD) was described [30], the data being, however, incoherent [33]. Low BMD values in IS were indicated in many studies [34] as a possible linkage between ESR1 polymorphism and IS. Estrogen receptor is expressed both in osteoblasts and osteoclasts [35], [36].…”

Polymorphism of rs2767485 in Leptin Receptor Gene is Associated With the Occurrence of Adolescent Idiopathic Scoliosis

“…10 , 22-24 In previous studies, patients with AIS were reported to have lower BMI, abnormal leptin bioavailability, and systemic lower bone mass compared with normal controls. 3,5,6,8,25 Together with the current fi nding that the polymorphisms of SNP rs2767485 in LEPR gene were associated with AIS, we can speculate that the abnormal functions of the LEPR gene may contribute to the occurrence of AIS. However, to elucidate the role of SNP rs2767485 in the expression of LEPR gene or the pathway involved for the development of AIS, further functional experiments will be required.…”

Halo Gravity Traction Is Associated with Reduced Bone Mineral Density of Patients with Severe Kyphoscoliosis

“…Low BMD status was found in many patients with spine deformity [15–17]. Li et al [26] suggest that the prevalence of low BMD in adolescents with AIS is 20% to 38%. A study by Lammert et al [17] showed that the BMD were significantly lower in NF1 patients than normal reference population.…”