European Spine Journal

, Volume 18, Issue 12, pp 1920–1926 | Cite as

Decreased osteogenic differentiation of mesenchymal stem cells and reduced bone mineral density in patients with adolescent idiopathic scoliosis

  • Weon Wook Park
  • Kuen Tak Suh
  • Jeung Il Kim
  • Seong-Jang Kim
  • Jung Sub Lee
Original Article


Generalized low bone mass and osteopenia in both axial and peripheral skeletons have been reported in adolescent idiopathic scoliosis (AIS). However, the mechanism and causes of bone loss in AIS have not been identified. Therefore, this study examined the relationship between the osteogenic and adipogenic differentiation abilities of mesenchymal stem cells (MSCs) and bone mass in 19 patients with AIS and compared these with those of 16 age- and gender-matched patients with lower leg fracture. Mean lumbar spinal bone mineral density (LSBMD) in AIS patients was found to be lower than in controls (P = 0.037) and the osteogenic differentiation abilities and alkaline phosphatase activities of MSCs from patients were also found to be lower than those of controls (P = 0.0073 and P = 0.001, respectively), but the abilities of the MSCs of patients and controls to undergo adipogenic differentiation were similar. The osteogenic differentiation ability was found to be positively correlated with alkaline phosphatase activity in the AIS group. However, the osteogenic and adipogenic abilities were not found to be correlated with LSBMD in either patients or controls. These findings suggest that the decreased osteogenic differentiation ability of MSCs might be one of the possible mechanisms leading to low bone mass in AIS. However, we did not determine definite mechanisms of low bone mass in AIS. Therefore, further study with large scale will be needed to identify the mechanism involved.


Adolescent idiopathic scoliosis Bone mineral density Mesenchymal stem cells Osteogenic differentiation ability 


  1. 1.
    Ahn UM, Ahn NU, Nallamshetty L, Buchowski JM, Rose PS, Miller NH, Kostuik JP, Sponseller PD (2002) The etiology of adolescent idiopathic scoliosis. Am J Orthop 31:387–395PubMedGoogle Scholar
  2. 2.
    Bergman RJ, Gazit D, Kahn AJ, Gruber H, McDougall S, Hahn TJ (1996) Age-related changes in osteogenic stem cells in mice. J Bone Miner Res 11:568–577PubMedCrossRefGoogle Scholar
  3. 3.
    Burner WL, Badger VM, Sherman FC (1982) Osteoporosis and acquired back deformities. J Pediatr Orthop 2:383–385PubMedGoogle Scholar
  4. 4.
    Cheng JC, Guo X (1997) Osteopenia in adolescent idiopathic scoliosis. A primary problem or secondary to the spinal deformity? Spine 22:1716–1721CrossRefPubMedGoogle Scholar
  5. 5.
    Cheng JC, Guo X, Sher AH (1999) Persistent osteopenia in adolescent idiopathic scoliosis. A longitudinal follow up study. Spine 24:1218–1222CrossRefPubMedGoogle Scholar
  6. 6.
    Cheng JC, Qin L, Cheung CS, Sher AH, Lee KM, Ng SW, Guo X (2000) Generalized low areal and volumetric bone mineral density in adolescent idiopathic scoliosis. J Bone Miner Res 15:1587–1595CrossRefPubMedGoogle Scholar
  7. 7.
    Cheng JC, Tang SP, Guo X, Chan CW, Qin L (2001) Osteopenia in adolescent idiopathic scoliosis: a histomorphometric study. Spine 26:E19–E23CrossRefPubMedGoogle Scholar
  8. 8.
    Cook SD, Harding AF, Morgan EL, Nicholson RJ, Thomas KA, Whitecloud TS, Ratner ES (1987) Trabecular bone mineral density in idiopathic scoliosis. J Pediatr Orthop 7:168–174PubMedGoogle Scholar
  9. 9.
    D’Ippolito G, Schiller PC, Ricordi C, Roos BA, Howard GA (1999) Age-related osteogenic potential of mesenchymal stromal stem cells from human vertebral bone marrow. J Bone Miner Res 14:1115–1122CrossRefPubMedGoogle Scholar
  10. 10.
    Ford DM, Bagnall KM, Clements CA, McFadden KD (1988) Muscle spindles in the paraspinal musculature of patients with adolescent idiopathic scoliosis. Spine 13:461–465CrossRefPubMedGoogle Scholar
  11. 11.
    Ford DM, Bagnall KM, McFadden KD, Greenhill BJ, Raso VJ (1984) Paraspinal muscle imbalance in adolescent idiopathic scoliosis. Spine 9:373–376CrossRefPubMedGoogle Scholar
  12. 12.
    Gimble JM, Robinson CE, Wu X, Kelly KA (1996) The function of adipocytes in the bone marrow stroma: an update. Bone 19:421–428CrossRefPubMedGoogle Scholar
  13. 13.
    Herman R, Mixon J, Fisher A, Maulucci R, Stuyck J (1985) Idiopathic scoliosis and the central nervous system: a motor control problem [The Harrington lecture 1983]. Scoliosis Research Society. Spine 10:1–14CrossRefPubMedGoogle Scholar
  14. 14.
    Ho S, Wong E, Chan SG, Lau J, Chan C, Leung PC (1997) Determinants of peak bone mass in Chinese women aged 21–40 years. III. Physical activity and bone mineral density. J Bone Miner Res 12:1262–1271CrossRefPubMedGoogle Scholar
  15. 15.
    Johnston CC Jr, Miller JZ, Slemenda CW, Reister TK, Hui S, Christian JC, Peacock M (1992) Calcium supplementation and increase in bone mineral density in children. N Engl J Med 327:82–87PubMedGoogle Scholar
  16. 16.
    Kindsfater K, Lowe T, Lawellin D, Weinstein D, Akmakjian J (1994) Levels of platelet calmodulin for the prediction of progression and severity of adolescent idiopathic scoliosis. J Bone Joint Surg 76-A:1186–1192Google Scholar
  17. 17.
    Machida M, Dubousset J, Imamura Y, Iwaya T, Yamada T, Kimura J, Toriyama S (1994) Pathogenesis of idiopathic scoliosis: SEPs in chicken with experimentally induced scoliosis and in patients with idiopathic scoliosis. J Pediatr Orthop 14:329–335PubMedGoogle Scholar
  18. 18.
    Majors AK, Boehm CA, Nitto H, Midura RJ, Muschler GF (1997) Characterization of human bone marrow stromal cells with respect to osteoblastic differentiation. J Orthop Res 15:546–557CrossRefPubMedGoogle Scholar
  19. 19.
    McCarrey JR, Abbott UK, Benson DR, Riggins RS (1981) Genetics of scoliosis in chickens. J Hered 72:6–10PubMedGoogle Scholar
  20. 20.
    Nilsson BE, Westlin NE (1971) Bone density in athletes. Clin Orthop 77:179–182PubMedGoogle Scholar
  21. 21.
    Nuttall ME, Patton AJ, Olivera DL, Nadeau DP, Gowen M (1998) Human trabecular bone cells are able to express both osteoblastic and adipocytic phenotype: implications for osteopenic disorders. J Bone Miner Res 13:371–382CrossRefPubMedGoogle Scholar
  22. 22.
    Pignolo RJ, Suda RK, McMillan EA, Shen J, Lee SH, Choi Y, Wright AC, Johnson FB (2008) Defects in telomere maintenance molecules impair osteoblast differentiation and promote osteoporosis. Aging Cell 7:23–31CrossRefPubMedGoogle Scholar
  23. 23.
    Rodriguez JP, Astudillo P, Rios S, Pino AM (2008) Involvement of adipogenic potential of human bone marrow mesenchymal stem cells (MSCs) in osteoporosis. Curr Stem Cell Res Ther 3:208–218CrossRefPubMedGoogle Scholar
  24. 24.
    Rodriguez JP, Garat S, Gajardo H, Pino AM, Seitz G (1999) Abnormal osteogenesis in osteoporotic patients is reflected by altered mesenchymal stem cells dynamics. J Cell Biochem 75:414–423CrossRefPubMedGoogle Scholar
  25. 25.
    Slemenda CW, Peacock M, Hui S, Zhou L, Johnston CC (1997) Reduced rates of skeletal remodeling are associated with increased bone mineral density the development of peak skeletal mass. J Bone Miner Res 12:676–682CrossRefPubMedGoogle Scholar
  26. 26.
    Smith FM, Latchford G, Hall RM, Millner PA, Dickson RA (2002) Indications of disordered eating behaviour in adolescent patients with idiopathic scoliosis. J Bone Joint Surg 84-B:392–394CrossRefGoogle Scholar
  27. 27.
    Stilwell DL Jr (1962) Structural deformities of vertebrae: bone adaptation and modeling in experimental scoliosis and kyphosis. J Bone Joint Surg 44-A:611–634PubMedGoogle Scholar
  28. 28.
    Suh KT, Lee SS, Hwang SH, Kim SJ, Lee JS (2007) Elevated soluble receptor activator of nuclear factor-κB ligand and reduced bone mineral density in patients with adolescent idiopathic scoliosis. Eur Spine J 16:1563–1569CrossRefPubMedGoogle Scholar
  29. 29.
    Suh KT, Lee SS, Kim SJ, Kim YK, Lee JS (2007) Pineal gland metabolism in patients with adolescent idiopathic scoliosis. J Bone Joint Surg 89-B:66–71CrossRefGoogle Scholar
  30. 30.
    Thomas KA, Cook SD, Skalley TC, Renshaw SV, Makuch RS, Gross M, Whitecloud TS 3rd, Bennett JT (1992) Lumbar spine and femoral neck bone mineral density in idiopathic scoliosis: a follow up study. J Pediatr Orthop 12:235–240PubMedGoogle Scholar
  31. 31.
    Wang ED, Drummond DS, Dormans JP, Moshang T, Davidson RS, Gruccio D (1997) Scoliosis in patients treated with growth hormone. J Pediatr Orthop 17:708–711CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Weon Wook Park
    • 1
  • Kuen Tak Suh
    • 2
  • Jeung Il Kim
    • 2
  • Seong-Jang Kim
    • 3
  • Jung Sub Lee
    • 2
  1. 1.Department of Orthopaedic SurgeryKorea HospitalPusanKorea
  2. 2.Department of Orthopaedic Surgery, Medical Research InstitutePusan National University School of MedicinePusanKorea
  3. 3.Department of Nuclear Medicine, Medical Research InstitutePusan National University School of MedicinePusanKorea

Personalised recommendations