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European Spine Journal

, Volume 18, Issue 2, pp 180–187 | Cite as

The role of spinal concave–convex biases in the progression of idiopathic scoliosis

  • Mark Driscoll
  • Carl-Eric AubinEmail author
  • Alain Moreau
  • Isabelle Villemure
  • Stefan Parent
Original Article

Abstract

Inadequate understanding of risk factors involved in the progression of idiopathic scoliosis restrains initial treatment to observation until the deformity shows signs of significant aggravation. The purpose of this analysis is to explore whether the concave–convex biases associated with scoliosis (local degeneration of the intervertebral discs, nucleus migration, and local increase in trabecular bone-mineral density of vertebral bodies) may be identified as progressive risk factors. Finite element models of a 26° right thoracic scoliotic spine were constructed based on experimental and clinical observations that included growth dynamics governed by mechanical stimulus. Stress distribution over the vertebral growth plates, progression of Cobb angles, and vertebral wedging were explored in models with and without the biases of concave–convex properties. The inclusion of the bias of concave–convex properties within the model both augmented the asymmetrical loading of the vertebral growth plates by up to 37% and further amplified the progression of Cobb angles and vertebral wedging by as much as 5.9° and 0.8°, respectively. Concave–convex biases are factors that influence the progression of scoliotic curves. Quantifying these parameters in a patient with scoliosis may further provide a better clinical assessment of the risk of progression.

Keywords

Scoliosis Growth modulation Hemiepiphysiodesis Finite element model 

Notes

Acknowledgments

Funded by the Natural Sciences and Engineering Research Council of Canada, Medtronic Sofamor Danek and the Canada Research Chair Program.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Mark Driscoll
    • 1
    • 2
  • Carl-Eric Aubin
    • 1
    • 2
    • 5
    Email author
  • Alain Moreau
    • 2
    • 3
    • 4
  • Isabelle Villemure
    • 1
    • 2
  • Stefan Parent
    • 2
  1. 1.Ecole Polytechnique de Montréal, Biomedical Engineering InstituteMontrealCanada
  2. 2.Research Center Sainte-Justine University HospitalMontrealCanada
  3. 3.Department of Stomatology, Faculty of DentistryUniversité de MontréalMontrealCanada
  4. 4.Department of Biochemistry, Faculty of MedicineUniversité de MontréalMontrealCanada
  5. 5.Ecole Polytechnique de Montreal, Mechanical Engineering DepartmentCanada Research Chair CAD Innovations in Orthopedic Engineering, NSERC/Medtronic Industrial Research Chair in Spine BiomechanicsMontrealCanada

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