Skip to main content
SpringerLink
Log in

Structural vertebral changes in the horizontal plane in idiopathic scoliosis and the long-term corrective effect of spine instrumentation

  • Original Articles
  • Published:
European Spine Journal Aims and scope Submit manuscript

Summary

The rotation and structural changes of the apex vertebra in the horizontal plane as well as of the thoracic cage deformity were quantified by measurements on computed tomography (CT) scans from patients with right convex thoracic idiopathic scoliosis (IS). The CT scans were obtained from 12 patients with moderate scoliosis (mean Cobb angle 25.8°, r 13°–30°) and from 33 with severe scoliosis (mean Cobb angle 46.2°, r 35°–71°). In addition, CT scans of thoracic vertebrae from 15 patients without scoliosis were used as reference material. Ten of the scoliotic cases had had Cotrel-Dubousset instrumentation (CDI) and posterior fusion and had entered a longitudinal study on the effect of operative correction on the re-modelling of the apical vertebra. An increasingly asymmetrical vertebral body, transverse process angle, pedicle width and canal width were found in the groups with scoliosis as compared with the reference material. Vertebral rotation and rib hump index were significantly larger in patients with early and advanced scoliosis than in normal subjects. The modelling angle of the vertebral body, the transverse process angle index and the vertebral rotation in relation to the middle axis of the thoracic cage were significantly greater in patients with severe than with moderate scoliosis. The results of this longitudinal study suggest that the structural changes of the apical vertebra regress 2 years or more after CD instrumentation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aaro S, Dahlborn, Svensson L (1981) Estimation of vertebral rotation and the spinal and rib cage deformity in scoliosis by computer tomography. Spine 6:460–467

    Google Scholar 

  2. Arkin AM (1949) The mechanism of structural changes in scoliosis. J Bone Joint Surg [Am] 31:519–527

    Google Scholar 

  3. Cobb JR (1948) Outline for the study of scoliosis. In: Edwards JW (ed) Instructional course lectures, 5. American Academy of Orthopedic Surgeons Ann Arbor, pp 261–275

    Google Scholar 

  4. Cundy PJ, Paterson DC, Hillier TM, Sutherland AD, Stephen JP, Foster B (1990) Cotrel-Dubousset instrumentation and vertebral rotation in adolescent idiopathic scoliosis. J Bone Joint Surg [Br] 72:670–764

    Google Scholar 

  5. Deacon P, Flood BM, Dickson RA (1984) Idiopathic scoliosis in three dimensions. A radiographic and morphometric analysis. J Bone Joint Surg [Br] 66:509–512

    Google Scholar 

  6. Deane G, Duthie RB (1973) A new projectional look at articulated scoliotic spines. Acta Orthop Scand 44:351–365

    Google Scholar 

  7. Dickson RA, Lawton JO, Archer IA, Butt WP (1984) The pathogenesis of idopathic scoliosis: biplanar spinal asymmetry. J Bone Joint Surg [Br] 66:8–15

    Google Scholar 

  8. Enneking WF, Harrington P (1969) Pathological changes in scoliosis. J Bone Joint Surg [Am] 51:165–184

    Google Scholar 

  9. Fabris D, Costantini S (1988) Vertebral rotation during the initial stages of scoliosis: the costovertebral interaction mechanism. Ital J Orthop Traumatol 14:59–66

    Google Scholar 

  10. Farkas A (1954) The pathogenesis of idiopathic scoliosis. J Bone Joint Surg [Am] 36:717–754

    Google Scholar 

  11. Frost HM (1992) Perspectives: bone's mechanical usage window. Bone Miner 19:257–271

    Google Scholar 

  12. Harrington PR (1976) Is scoliosis reversible? In vivo observations of reversible morphological changes in the production of scoliosis in mice. Clin Orthop 116:103–111

    Google Scholar 

  13. Harrington PR (1977) The etiology of idiopathic scoliosis. Clin Orthop 126:17–25

    Google Scholar 

  14. James JIP (1951) Two curve patterns in idiopathic structural scoliosis. J Bone Joint Surg [Br] 33:399–406

    Google Scholar 

  15. James JIP (1970) The etiology of scoliosis. J Bone Joint Surg [Br] 52:410–429

    Google Scholar 

  16. Karaharju EO (1967) Deformation of vertebrae in experimental scoliosis. The cause of bone adaptation and modeling in scoliosis with reference to the normal growth of the vertebra. Acta Orthop Scand Suppl 105

  17. Knutsson F (1963) Contribution to the discussion of the biological cause of idiopathic scoliosis. Acta Orthop Scand 33: 98–104

    Google Scholar 

  18. Knutsson F (1966) Vertebral genesis in idiopathic scoliosis in children. Acta Radiol 4:395–402

    Google Scholar 

  19. Lloyd-Roberts GC, Pincott JR, McMeniman P, Bayley IJL, Kendall B (1978) Progression in idiopathic scoliosis. A preliminary report of a possible mechanism. J Bone Joint Surg [Br] 60:451–460

    Google Scholar 

  20. Michelsson JE (1965) The development of spinal deformity in experimental scoliosis. Acta Orthop Scand Suppl 81

  21. Miles M (1944) Lateral vertebral dimensions and lateral spinal curvature. Hum Biol 16:153–171

    Google Scholar 

  22. Moe JH, Winter RB, Bradford DS, Lonstein JE (1978) Scoliosis and other spinal deformities. WB Saunders, Philadelphia

    Google Scholar 

  23. Perdriolle R, Vidal J (1985) Thoracic idiopathic scoliosis curve evolution and progression. Spine 10:785–791

    Google Scholar 

  24. Perdriolle R, Becchetti S, Vidal J, Lopez P (1993) Mechanical process and growth cartilages. Essential factors in the progression of scoliosis. Spine 18:343–349

    Google Scholar 

  25. Ponseti IV, Pedrini V, Wynne-Davies R, Duval-Beaupere G (1976) Pathogenesis of scoliosis. Clin Orthop 120:268–280

    Google Scholar 

  26. Risser JC (1964) Scoliosis: past and present. J Bone Joint Surg [Am] 46:167–199

    Google Scholar 

  27. Roaf R (1958) Rotation movements of the spine with special reference to scoliosis. J Bone Joint Surg [Br] 40:312–332

    Google Scholar 

  28. Roaf R (1960) Vertebral growth and its mechanical control. J Bone Joint Surg [Br] 42:40–59

    Google Scholar 

  29. Roaf R (1966) The basic anatomy of scoliosis. J Bone Joint Surg [Br] 48:786–792

    Google Scholar 

  30. Smith RM, Pool RD, Butt WP, Dickson RA (1991) The transverse plane deformity of structural scoliosis. Spine 16:1126–1129

    Google Scholar 

  31. Somerville EW (1952) Rotational lordosis: the development of the single curve. J Bone Joint Surg [Br] 34:421–427

    Google Scholar 

  32. Taylor JR (1983) Scoliosis and growth. Patterns of asymmetry in normal vertebral growth. Acta Orthop Scand 54:596–602

    Google Scholar 

  33. Thulbourme T, Gillespie R (1976) The rib hump in idiopatiic scoliosis. J Bone Joint Surg [Br] 58:64–71

    Google Scholar 

  34. Willers U, Hedlund R, Aaro S (1993) Mid-term effects of Cotrel-Dubousset instrumentation on the configuration of the spine and the thoracic cage in thoracic idiopathic scoliosis. Eur Spine J 2:99–103

    Google Scholar 

  35. Xiong B, Sevastik J, Hedlund R, Sevastik B (1994) Radiographic changes at coronal plane in early scoliosis. Spine 19:159–164

    Google Scholar 

  36. Xiong B, Sevastik J, Hedlund R, Sevastik B (1994) Sagittal configuration of the spine and growth of the posterior elements in early scoliosis. J Orthop Res (in press)

  37. Xiong B, Sevastik B, Sevastik J, Hedlund R, Suliman I, Kristjansson S (1994) Horizontal plane morphometry of normal and scoliotic vertebra. A methodological study. Eur Spine J 4:6–10

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden

    B. Xiong, B. Sevastik, U. Willers, J. Sevastik & R. Hedlund

Authors
  1. B. Xiong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Sevastik
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. U. Willers
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J. Sevastik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R. Hedlund
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Xiong, B., Sevastik, B., Willers, U. et al. Structural vertebral changes in the horizontal plane in idiopathic scoliosis and the long-term corrective effect of spine instrumentation. Eur Spine J 4, 11–14 (1995). https://doi.org/10.1007/BF00298411

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00298411

Key words

Search

Navigation