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

Abstract

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.

Association Between Components of Body Composition and Scoliosis: A Prospective Cohort Study Reporting Differences Identifiable Before the Onset of Scoliosis

“…Furthermore, we have identified differences in function of adipose tissue as assessed by adipocyte-derived hormone levels at age 10 years, before the onset of clinically detectable scoliosis. Our results are consistent with the results of previous case-control studies, (11)(12)(13)(14)(15)(16)(17) but the effect size is smaller. Our findings suggest that the association between lower body weight and an increased risk of scoliosis is not due to bias and is explained by differences in both fat and lean mass.…”

Abnormal Leptin Bioavailability in Adolescent Idiopathic Scoliosis

“…6 However, in the study of Qiu et al , 26 20% of circulation and enhance the leptin bioavailability in CSF. 37 , 44 Along with other studies, 6,9,10,14,16,45,46 AIS girls were found to have signifi cantly lower BMI and longer arm span than the healthy controls. This matches our observation on the change of sOB-R and FLI level in AIS girls.…”

Polygenic Threshold Model with Sex Dimorphism in Adolescent Idiopathic Scoliosis: The Carter Effect

“…Several studies have indicated an association between estrogen receptor polymorphisms and scoliosis 19,20 , and another study indicated that girls with scoliosis had a tendency toward later menarche compared with girls who did not develop . Lower bone mineral density and disturbances in bone metabolism have also been related to AIS [33][34][35][36][37] ; the structural differences between males and females could contribute to the sex dimorphism of scoliosis. One study indicated that decreased differentiation ability of mesenchymal stem cells may contribute to osteopenia in individuals with AIS 38 .…”