The role of spinal concave–convex biases in the progression of idiopathic scoliosis
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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.
KeywordsScoliosis Growth modulation Hemiepiphysiodesis Finite element model
Funded by the Natural Sciences and Engineering Research Council of Canada, Medtronic Sofamor Danek and the Canada Research Chair Program.
- 12.Huynh A, Aubin CE, Mathieu P, Labelle H (2007) Simulation of progressive spinal deformities in duchenne muscular dystrophy using a biomechanical model integrating muscle and vertebral growth modulation. Clin Biomech (Bristol, Avon) 22:392–399. doi: 10.1016/j.clinbiomech.2006.11.010 CrossRefGoogle Scholar
- 30.Price J, Oyajobi B, Russell R (1994) The cell biology of bone growth. Eur J Clin Nutr 48:131–149Google Scholar
- 38.Villemure I, Aubin CE, Dansereau J (2002) Simulation of progressive deformities in adolescent idiopathic scoliosis using a biomechanical model integrating vertebral growth. J Biomed Eng 124(6):784–790Google Scholar
- 41.Wolff J (1892) Das Gesetz der Transformation der Knoche. Hirshwald, BerlinGoogle Scholar