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Changes in peri-apical vertebral body and intervertebral disc shape in both the sagittal and coronal planes correlate with scoliosis severity: a 3D study of 397 patients

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Abstract

Purpose

To evaluate associations between vertebrae and disc shape asymmetry and adolescent idiopathic scoliosis (AIS) curve severity.

Methods

Analysis included normal screening referrals and patients with right, main thoracic AIS who underwent upright, biplanar radiographs with 3D reconstruction at a single institution from 2010 to 2015. Peri-apical anterior, posterior, right, and left vertebral body heights (aVBH, pVBH, rVBH, lVBH) and intervertebral disc heights (DH) were measured, and ratios of these measurements were calculated in sagittal and coronal planes. Correlations were performed between curve severity and height measurements. Sagittal and coronal plane components of these measurements were compared between normal controls with coronal curve measurements < 11° and patients with moderate (11°–49°) and severe curves (≥ 50°), with tolerance intervals established for the normal controls.

Results

The analysis included a total of 397 patients. Patients with AIS had coronal curve measurements ranging from 11° to 101°. Greater coronal curve severity strongly correlated with smaller pVBH relative to aVBH and moderately correlated with smaller pDH relative to aDH (r = − 0.643, r = − 0.305, respectively). aVBH was greater for larger curves; pVBH remained stable. Scoliosis severity strongly correlated with right relative to left VBH and DH ratios (r = 0.919, r = 0.865 respectively). In comparison of normal controls to severe curves, severe curves had significantly greater aVBH and aDH, while pVBH was not significantly different and pDH was significantly less. Nearly half (46.9%) of the severe curves were below the range of normal for PA vertebral height ratio.

Conclusion

In right, main thoracic AIS, greater main thoracic curve severity is associated with greater sagittal and coronal plane asymmetry of both the vertebral bodies and the discs. Severity more strongly correlates with vertebral changes in symmetry than with disc changes, though both are present.

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Funding

This work was funded in part by the Rady Children’s Spine Center Research Fund and in part by research grants to Setting Scoliosis Straight Foundation from DePuy Synthes Spine, EOS imaging, K2M, Medtronic, NuVasive and Zimmer Biomet in support of Harms Study Group research.

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Authors and Affiliations

  1. Department of Orthopaedics, University of California, 3020 Children’s Way, MC 5062, San Diego, CA, 92123, USA

    T. Barrett Sullivan & Peter O. Newton

  2. Division of Orthopedics and Scoliosis, Rady Children’s Hospital, San Diego, CA, USA

    Tracey P. Bastrom, Fredrick Reighard, Megan Jeffords, Carrie E. Bartley & Peter O. Newton

Authors
  1. T. Barrett Sullivan
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  2. Tracey P. Bastrom
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  3. Fredrick Reighard
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  4. Megan Jeffords
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  5. Carrie E. Bartley
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  6. Peter O. Newton
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Contributions

Conception or design of the work; or acquisition, analysis, or interpretation of data for the work: TBS, TPB, CEB, FR, MJ, PON. Drafting or critically revising the work: TBS, TPB, CEB, FR, MJ, PON. Final approval of the version to be published: TBS, TPB, CEB, FR, MJ, PON.

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Correspondence to Peter O. Newton.

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One or more of the authors reports funding to their institution related to the submitted work and financial relationships with entities outside of the submitted work. Details of which can be found in the individual author disclosure forms submitted with this manuscript.

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IRB approval was obtained for this study.

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Sullivan, T.B., Bastrom, T.P., Reighard, F. et al. Changes in peri-apical vertebral body and intervertebral disc shape in both the sagittal and coronal planes correlate with scoliosis severity: a 3D study of 397 patients. Spine Deform 9, 959–967 (2021). https://doi.org/10.1007/s43390-021-00293-8

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  • DOI: https://doi.org/10.1007/s43390-021-00293-8

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