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

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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.

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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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Authors and Affiliations

  1. Ecole Polytechnique de Montréal, Biomedical Engineering Institute, P.O. Box 6079, Station Centre Ville, Montreal, QC, H3C 3A7, Canada

    Mark Driscoll, Carl-Eric Aubin & Isabelle Villemure

  2. Research Center Sainte-Justine University Hospital, 3175 Cote Sainte-Catherine Road, Montreal, QC, H3T 1C5, Canada

    Mark Driscoll, Carl-Eric Aubin, Alain Moreau, Isabelle Villemure & Stefan Parent

  3. Department of Stomatology, Faculty of Dentistry, Université de Montréal, PO Box 6128, Sation Centre Ville, Montreal, QC, H3C 3J7, Canada

    Alain Moreau

  4. Department of Biochemistry, Faculty of Medicine, Université de Montréal, PO Box 6128, Sation Centre Ville, Montreal, QC, H3C 3J7, Canada

    Alain Moreau

  5. Ecole Polytechnique de Montreal, Mechanical Engineering Department, Canada Research Chair CAD Innovations in Orthopedic Engineering, NSERC/Medtronic Industrial Research Chair in Spine Biomechanics, P.O. Box 6079, Station Centre Ville, Montreal, QC, H3C 3A7, Canada

    Carl-Eric Aubin

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  1. Mark Driscoll
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Correspondence to Carl-Eric Aubin.

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Driscoll, M., Aubin, CE., Moreau, A. et al. The role of spinal concave–convex biases in the progression of idiopathic scoliosis. Eur Spine J 18, 180–187 (2009). https://doi.org/10.1007/s00586-008-0862-z

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  • DOI: https://doi.org/10.1007/s00586-008-0862-z

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