Benedikt Schlager1, Florian Krump1, Julius Boettinger1, Frank Niemeyer1, Michael Ruf2, Sebastian Kleiner3, Meinrad Beer3, Hans-Joachim Wilke4. 1. Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081, Ulm, Germany. 2. SRH Klinikum Karlsbad-Langensteinbach gGmbH, Zentrum für Wirbelsäulenchirurgie, Orthopädie und Unfallchirurgie, Guttmannstraße 1, 76307, Karlsbad, Germany. 3. Klinik für Diagnostische und Interventionelle Radiologie, Ulm University Medical Centre, Albert-Einstein-Allee 29, 89081, Ulm, Germany. 4. Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm, Ulm University Medical Centre, Helmholtzstraße 14, 89081, Ulm, Germany. hans-joachim.wilke@uni-ulm.de.
Abstract
PURPOSE: Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine which exhibits morphological changes during growth. The goal of this study was to identify morphological patterns that could be explained by different loading patterns for AIS. METHODS: Computed tomography data of 21 patients with diagnosed AIS and 48 patients without any visual spinal abnormalities were collected prospectively. The bony structures were reconstructed, and landmarks were placed on characteristic morphological points on the spine. Multiple morphological parameters were calculated based on the distances between the landmarks. The intra- and inter-observer variability for each parameter was estimated. Differences between healthy and scoliotic spines were statistically analysed using the t test for unpaired data, with a significance level of α = 0.01. RESULTS: Within the healthy group, an out-of-plane rotation of the vertebrae in the transverse plane was measured (2.6° ± 4.1° at T2). Relating the length of the spinal curvature to the T1-S1 height of the spine revealed that scoliotic spines were significantly longer. However, the endplate area in the AIS group was significantly smaller once compared to the curvature length. The relation between the left and right pedicle areas varied between 2.5 ± 0.79 and 0.4 ± 0.19, while the ratio of the facet articular surfaces varied within 2.3 ± 0.5 and 0.5 ± 0.2. CONCLUSIONS: This study identified a certain morphological pattern along the spine, which reveals a distinct load path prevalent within AIS. The data suggested that the spine adapts to the asymmetric load conditions and the spine is not deformed by asymmetric growth disturbance. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE:Adolescent idiopathic scoliosis (AIS) is a three-dimensional deformity of the spine which exhibits morphological changes during growth. The goal of this study was to identify morphological patterns that could be explained by different loading patterns for AIS. METHODS: Computed tomography data of 21 patients with diagnosed AIS and 48 patients without any visual spinal abnormalities were collected prospectively. The bony structures were reconstructed, and landmarks were placed on characteristic morphological points on the spine. Multiple morphological parameters were calculated based on the distances between the landmarks. The intra- and inter-observer variability for each parameter was estimated. Differences between healthy and scoliotic spines were statistically analysed using the t test for unpaired data, with a significance level of α = 0.01. RESULTS: Within the healthy group, an out-of-plane rotation of the vertebrae in the transverse plane was measured (2.6° ± 4.1° at T2). Relating the length of the spinal curvature to the T1-S1 height of the spine revealed that scoliotic spines were significantly longer. However, the endplate area in the AIS group was significantly smaller once compared to the curvature length. The relation between the left and right pedicle areas varied between 2.5 ± 0.79 and 0.4 ± 0.19, while the ratio of the facet articular surfaces varied within 2.3 ± 0.5 and 0.5 ± 0.2. CONCLUSIONS: This study identified a certain morphological pattern along the spine, which reveals a distinct load path prevalent within AIS. The data suggested that the spine adapts to the asymmetric load conditions and the spine is not deformed by asymmetric growth disturbance. These slides can be retrieved under Electronic Supplementary Material.
Authors: Winnie C W Chu; H Y Yeung; W W Chau; Wynnie W M Lam; B K W Ng; T P Lam; K M Lee; Jack C Y Cheng Journal: Stud Health Technol Inform Date: 2006
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