Skip to main content
SpringerLink
Log in

Asymmetric evolution of anterior chest wall blood supply in female adolescents with progressive right-convex thoracic idiopathic scoliosis

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

Abstract

Breast asymmetry was believed to be related to asymmetry of anterior chest wall blood supply and subsequently to aetiology of idiopathic thoracic scoliosis in female adolescents. Recent investigations on the anterior chest wall blood supply with Colour Doppler Ultrasonography (CDU) in such individuals did not show anatomical and hemodynamic abnormalities. The present study investigated the evolution of anterior chest wall blood supply in these individuals over a 2-year period. Twenty female adolescents with progressive right-convex idiopathic thoracic scoliosis (scoliotics), who were during the study in therapy with horacolumbosacral orthosis (TLSO) and 20 age-matched girls, without spine deformity (controls) were studied with CDU [internal mammary artery (IMA)] twice within the 2-year period. IMA-anatomical parameters [lumen diameter (D) and cross sectional area (AR)] as well as hemodynamic flow parameters [time average mean flow velocity and flow volume per minute (FV)] were measured. In the 2-year-period of observation, TLSO prevented scoliosis progression (P = 0.004), while IMA-AR decreased bilaterally in the individuals of both groups (P < 0.03). In the last evaluation: in scoliotics right IMA FV decreased (P < 0.04), while in controls IMA FV decreased bilaterally (P < 0.03); left IMA FV was significantly higher (P < 0.05) in scoliotics than in controls. The significant, within the 2-year period, decrease of IMA-diameter, cross-sectional area, and flow volume seems to be a physiological ageing process because it was observed in all individuals (scoliotics and controls), and thus these anatomic and hemodynamic changes seem not to have been affected by bracing. The maintenance of left flow volume of IMA in the pre-brace levels in scoliotics was the most significant finding of this investigation. In conclusion, this study provided evidence for abnormalities in the evolution of anterior chest wall blood supply in female adolescents with progressive right-convex female thoracic scoliosis. Further studies are needed to investigate if this asymmetric blood evolution contributes to the development of this pattern of scoliosis in girls.

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. Ehrsam JE, Spittell PC, Seward JB (1998) Internal mammary artery: 100% visualisation with new ultrasound technology. J Am Soc Echocardiogr 11:10–12

    Article  PubMed  CAS  Google Scholar 

  2. Fernandez-Feliberti R, Flynn J, Ramirez N, Trautmann M, Alegria M (1995) Effectiveness of TLSO bracing in the conservative treatment of idiopathic scoliosis. J Pediatr Orthop 15:176–181

    PubMed  CAS  Google Scholar 

  3. Hanks GA, Zimmer B, Nogi J (1988) TLSO treatment of idiopathic scoliosis. An analysis of the Wilmington jacket. Spine 13:626–629

    Article  PubMed  CAS  Google Scholar 

  4. Howard A, Wright JG et al (1998) A comparative study of TLSO, Charleston, and Milwaukee Braces for idiopathic scoliosis. Spine 23(22):2404–2411

    Article  PubMed  CAS  Google Scholar 

  5. Iwao T, Toyonaga A, Shigemori H et al (1996) Echo-Doppler measurements of portal vein and superior mesenteric artery blood flow in humans: inter- and intra-observer short-term reproducibility. J Gastroenterol Hepatol 11(1):40–46

    PubMed  CAS  Google Scholar 

  6. Korovessis P Iliopoulos P et al (2003) Colour Doppler ultrasonography for evaluation of internal mammary artery application in adolescent female patients with right-convex thoracic idiopathic scoliosis. Spine 28:1746–1748

    Article  Google Scholar 

  7. Korovessis P Iliopoulos P et al (2004) Colour Doppler ultrasonography for evaluation of anterior chest blood supply: the possible role of arterial blood supply to the costosternal junction in the aetiology of idiopathic scoliosis in female adolescents. Eur Spine J 13:44–48

    Article  Google Scholar 

  8. Korovessis P Iliopoulos P et al (2003) The association between arterial blood supply to the anterior chest and juxta-apical thorax-asymmetry-associated right thoracic female adolescent idiopathic scoliosis. Eur J Orthop Surg Traumatol 13:137–141

    Article  Google Scholar 

  9. Korovessis P, Kyrkos C, Piperos G, Soucacos PN (2000) Effects of thoracolumbosacral orthosis on spinal deformities, trunk asymmetry, and frontal lower rib cage in adolescent idiopathic scoliosis. Spine 25:2064–2071

    Article  PubMed  CAS  Google Scholar 

  10. Marx R, Sons H, Losse B, Bircks W(1994) Principles of duplex ultrasound diagnosis of the internal thoracic artery. Z Kardiol 83:804–808

    PubMed  CAS  Google Scholar 

  11. Normeli H, Sevastik J, Walberg H (1986) The thermal emission from the skin and the vascularity of breasts in normal and scoliotic girls. Spine 11:405–408

    Article  Google Scholar 

  12. Normeli H, Sevastik JA, Ljung G et al (1986) The symmetry of the breasts in normal and scoliotic girls. Spine 11:749–752

    Article  Google Scholar 

  13. Sevastik JA (2002) Dysfunction of the autonomic nerve system (ANS) in the aetiopathogenesis of adolescent idiopathic scoliosis. Stud Health Technol Inform 88:20–23

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopaedic Department, General Hospital “Agios Andreas”, 1 Tsertidou str., 65-67 Haralabi str., 26224, Patras, Greece

    Panagiotis Korovessis, Georgios Koureas & Spyridon Zacharatos

  2. Institute for Radiology, General Hospital “Agios Andreas”, Patras, Greece

    Panagiotis Iliopoulos & Panagiotis Stergiou

Authors
  1. Panagiotis Iliopoulos
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Panagiotis Korovessis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Georgios Koureas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Spyridon Zacharatos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Panagiotis Stergiou
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Panagiotis Korovessis.

Additional information

A reviewer’s comment on this paper is available at http://www.dx.doi.org/10.1007/s00586-007-0323-0.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Iliopoulos, P., Korovessis, P., Koureas, G. et al. Asymmetric evolution of anterior chest wall blood supply in female adolescents with progressive right-convex thoracic idiopathic scoliosis. Eur Spine J 16, 1343–1347 (2007). https://doi.org/10.1007/s00586-007-0322-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-007-0322-1

Keywords

Search

Navigation