Sagittal curvature of the spine as a predictor of the pediatric spinal deformity development.
Adolescent idiopathic scoliosis
Elastic rod
Finite element analysis
Pathogenesis
Sagittal profile
Spine
Journal
Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
14
09
2020
accepted:
19
12
2020
pubmed:
16
1
2021
medline:
19
11
2021
entrez:
15
1
2021
Statut:
ppublish
Résumé
The sagittal curvature of the spine is hypothesized to play an important role in induction of spinal deformities in adolescent idiopathic scoliosis. We previously showed an S shaped flexible rod, with the same curvature as the pediatric sagittal spinal curve, produces scoliotic-like deformities under physiologic loading. Yet, detailed characteristics of the pediatric sagittal spinal curves associated with higher risk of scoliosis are not well defined. A total of 32 patients in a population with a high prevalence of idiopathic-like scoliosis, 22q11.2 deletion syndrome (22q), were included and followed up for at least two-years. We developed a reduced order finite element model (FEM) of the sagittal profile of these 32 patients where the spine was modeled as an S shaped elastic rod. We related the geometrical parameters of the sagittal curves and the deformed FEM of the corresponding S shaped rods to the risk of scoliosis development at two-year follow-up in this cohort. Variations in the sagittal curvature in the cohort of 22q patients resulted in five different deformity patterns shown by finite element analyses. Two sagittal plane deformity pattern groups had high rate of scoliosis development (86% and 100%) whereas the other 3 groups had less than 50% rate of scoliosis development (40%, 33%, and 0%). The pre-scoliotic position of the inflection point (where lordosis turns into kyphosis), the ratio of the spinal curvatures above and below the inflection point, and the length of the spinal curve above and below the inflection point were significantly different between the five deformity patterns groups, p < 0.05. Combination of geometrical parameters of the sagittal profile prior to onset of scoliosis can relate to the development of spinal deformity in pediatric population.
Sections du résumé
BACKGROUND
The sagittal curvature of the spine is hypothesized to play an important role in induction of spinal deformities in adolescent idiopathic scoliosis. We previously showed an S shaped flexible rod, with the same curvature as the pediatric sagittal spinal curve, produces scoliotic-like deformities under physiologic loading. Yet, detailed characteristics of the pediatric sagittal spinal curves associated with higher risk of scoliosis are not well defined.
METHODS
A total of 32 patients in a population with a high prevalence of idiopathic-like scoliosis, 22q11.2 deletion syndrome (22q), were included and followed up for at least two-years. We developed a reduced order finite element model (FEM) of the sagittal profile of these 32 patients where the spine was modeled as an S shaped elastic rod. We related the geometrical parameters of the sagittal curves and the deformed FEM of the corresponding S shaped rods to the risk of scoliosis development at two-year follow-up in this cohort.
RESULTS
Variations in the sagittal curvature in the cohort of 22q patients resulted in five different deformity patterns shown by finite element analyses. Two sagittal plane deformity pattern groups had high rate of scoliosis development (86% and 100%) whereas the other 3 groups had less than 50% rate of scoliosis development (40%, 33%, and 0%). The pre-scoliotic position of the inflection point (where lordosis turns into kyphosis), the ratio of the spinal curvatures above and below the inflection point, and the length of the spinal curve above and below the inflection point were significantly different between the five deformity patterns groups, p < 0.05.
CONCLUSION
Combination of geometrical parameters of the sagittal profile prior to onset of scoliosis can relate to the development of spinal deformity in pediatric population.
Identifiants
pubmed: 33449344
doi: 10.1007/s43390-020-00279-y
pii: 10.1007/s43390-020-00279-y
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
923-932Subventions
Organisme : NIAMS NIH HHS
ID : R21 AR075971
Pays : United States
Organisme : national institute of health
ID : R21AR075971
Informations de copyright
© 2021. Scoliosis Research Society.
Références
Roaf R (1966) The basic anatomy of scoliosis. J Bone Joint Surg Br 48:786–792
doi: 10.1302/0301-620X.48B4.786
Kouwenhoven JW, Smit TH, van der Veen AJ, Kingma I, van Dieën JH, Castelein RM (2007) Effects of dorsal versus ventral shear loads on the rotational stability of the thoracic spine: a biomechanical porcine and human cadaveric study. Spine (Phila Pa 1976) 32:2545–2550. doi: https://doi.org/10.1097/BRS.0b013e318158cd86
Stokes IA, Burwell RG, Dangerfield PH, IBSE, (2006) Biomechanical spinal growth modulation and progressive adolescent scoliosis–a test of the “vicious cycle” pathogenetic hypothesis: summary of an electronic focus group debate of the IBSE. Scoliosis 1:16. https://doi.org/10.1186/1748-7161-1-16
doi: 10.1186/1748-7161-1-16
pubmed: 17049077
pmcid: 1626075
Guo X, Chau WW, Chan YL, Cheng JC (2003) Relative anterior spinal overgrowth in adolescent idiopathic scoliosis. Results of disproportionate endochondral-membranous bone growth. J Bone Joint Surg Br 85:1026–1031. https://doi.org/10.1302/0301-620x.85b7.14046
doi: 10.1302/0301-620x.85b7.14046
pubmed: 14516040
Burwell RG (2003) Aetiology of idiopathic scoliosis: current concepts. Pediatr Rehabil 6:137–170. https://doi.org/10.1080/13638490310001642757
doi: 10.1080/13638490310001642757
pubmed: 14713582
Schlösser TP, Shah SA, Reichard SJ, Rogers K, Vincken KL, Castelein RM (2014) Differences in early sagittal plane alignment between thoracic and lumbar adolescent idiopathic scoliosis. Spine J 14:282–290. https://doi.org/10.1016/j.spinee.2013.08.059
doi: 10.1016/j.spinee.2013.08.059
pubmed: 24231781
Neelakantan S, Purohit PK, Pasha S (2020) A Semi-Analytic Elastic Rod Model of Pediatric Spinal Deformity. J Biomech Eng. https://doi.org/10.1115/1.4048400 Accessed 10 Sep 2020
doi: 10.1115/1.4048400
Pasha S (2019) 3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis In. Scientific Reports 9(1):16485
doi: 10.1038/s41598-019-53068-7
Pasha S (2020) What causes different coronal curve patterns in idiopathic scoliosis? bioRxiv. https://doi.org/10.1101/2020.01.21.913707
Neelakantan S, Purohit PK, Pasha S (2020) A reduced-order model of the spine to study pediatric scoliosis. Biomech Model Mechanobiol. https://doi.org/10.1007/s10237-020-01394-5 . Accessed 13 Oct 2020
Homans JF, Baldew VGM, Brink RC, Kruyt MC, Schlösser TPC, Houben ML, Deeney VFX, Crowley TB, Castelein RM, McDonald-McGinn DM (2019) Scoliosis in association with the 22q11.2 deletion syndrome: an observational study. Arch Dis Child 104:19–24. https://doi.org/10.1136/archdischild-2018-314779
doi: 10.1136/archdischild-2018-314779
pubmed: 29627765
Pasha S, Capraro A, Cahill PJ, Dormans JP, Flynn JM (2016) Bi-planar spinal stereoradiography of adolescent idiopathic scoliosis: considerations in 3D alignment and functional balance. Eur Spine J 25:3234–3241. https://doi.org/10.1007/s00586-016-4661-7
doi: 10.1007/s00586-016-4661-7
pubmed: 27334494
Cobb J (1948) Outline for the study of scoliosis. Am Acad Orthop Surg Inst Lect 5:261–275
Pasha S, Hassanzadeh P, Ecker M, Ho V (2019) A hierarchical classification of adolescent idiopathic scoliosis: Identifying the distinguishing features in 3D spinal deformities. PLoS ONE 14:e0213406. https://doi.org/10.1371/journal.pone.0213406
doi: 10.1371/journal.pone.0213406
pubmed: 30893327
pmcid: 6426223
Castelein RM, van Dieën JH, Smit TH (2005) The role of dorsal shear forces in the pathogenesis of adolescent idiopathic scoliosis–a hypothesis. Med Hypotheses 65:501–508. https://doi.org/10.1016/j.mehy.2005.03.025
doi: 10.1016/j.mehy.2005.03.025
pubmed: 15913901
Legar JC (1999) Menger curvature and rectifiability. Ann Math 149:831–869
doi: 10.2307/121074
Pasha S, Aubin CE, Labelle H, Parent S, Mac-Thiong JM (2015) The biomechanical effects of spinal fusion on the sacral loading in adolescent idiopathic scoliosis. Clin Biomech (Bristol, Avon) 30:981–987. https://doi.org/10.1016/j.clinbiomech.2015.06.019
doi: 10.1016/j.clinbiomech.2015.06.019
de Reuver S, Brink RC, Homans JF, Kruyt MC, van Stralen M, Schlösser TPC, Castelein RM (2019) The Changing Position of the Center of Mass of the Thorax During Growth in Relation to Pre-existent Vertebral Rotation. Spine (Phila Pa 1976) 44:679–684. doi: https://doi.org/10.1097/BRS.0000000000002927
Londono D, Kou I, Johnson TA, Sharma S, Ogura Y, Tsunoda T, Takahashi A, Matsumoto M, Herring JA, Lam TP, Wang X, Tam EM, Song YQ, Fan YH, Chan D, Cheah KS, Qiu X, Jiang H, Huang D, TSRHC IS Clinical Group, International Consortium for Scoliosis Genetics, Su P, Sham P, Cheung KM, Luk KD, Gordon D, Qiu Y, Cheng J, Tang N, Ikegawa S, Wise CA, Group JSCR (2014) A meta-analysis identifies adolescent idiopathic scoliosis association with LBX1 locus in multiple ethnic groups. J Med Genet 51:401–406. https://doi.org/10.1136/jmedgenet-2013-102067
doi: 10.1136/jmedgenet-2013-102067
Xu L, Wu Z, Xia C, Tang N, Cheng JCY, Qiu Y, Zhu Z (2019) A Genetic Predictive Model Estimating the Risk of Developing Adolescent Idiopathic Scoliosis. Curr Genomics 20:246–251. https://doi.org/10.2174/1389202920666190730132411
doi: 10.2174/1389202920666190730132411
pubmed: 32030084
pmcid: 6983957
Pasha S, Baldwin K (2019) Preoperative Sagittal Spinal Profile of Adolescent Idiopathic Scoliosis Lenke Types and Non-Scoliotic Adolescents: A Systematic Review and Meta-Analysis. Spine (Phila Pa 1976) 44:134–142. https://doi.org/10.1097/BRS.0000000000002748
René M Castelein, Saba Pasha, Jack CY Cheng, Jean Dubousset (2020) Idiopathic Scoliosis as a Rotatory Decompensation of the Spine. J Bone Miner Res 35 (10):1850–1857
doi: 10.1002/jbmr.4137