A longitudinal study of growth velocity and development of secondary gender characteristics versus onset of idiopathic scoliosis.

School of Medicine, University of Zagreb, Department of Orthopedic Surgery, Salata, Yugoslavia.
Clinical Orthopaedics and Related Research (Impact Factor: 2.88). 10/1991;
Source: PubMed

ABSTRACT This study focused on evaluating the impact of the adolescent growth spurt on the onset of idiopathic scoliosis. A total of 698 students (362 girls and 336 boys aged nine to 12 years) were followed for three years to study their growth in the pubertal period and changes in spinal status. Every six months measurements were taken of body height and the development of secondary gender characteristics was recorded. The onset of the adolescent growth spurt could thus be detected in each child. When children with and without scoliosis were compared, it became evident that scoliotic children grew faster. Girls whose scoliosis developed from a previously normal body posture showed a peak height velocity (PHV) of 8.1 cm per year, whereas girls with a normal body posture throughout the pubertal stage had a PHV of 7.1 cm per year. The most rapid growth spurt was observed in Stages 2 and 3 of breast and pubic hair development. Simultaneously, the most frequent spinal status changes occurred in Stages 2 and 3 of sexual maturity; they were twice as frequent as in Stage 1 and four times as frequent as in Stages 4 and 5. Students in whom scoliosis developed in puberty during the adolescent growth spurt grew faster than their peers who did not develop scoliosis, which need not imply that they will eventually be taller after growth is completed.

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    ABSTRACT: Vertebral wedging is associated with spinal deformity progression in adolescent idiopathic scoliosis. Reporting frontal and sagittal wedging separately could be misleading since these are projected values of a single three-dimensional deformation of the vertebral body. The objectives of this study were to determine if three-dimensional vertebral body wedging is present in mild scoliosis and if there are a preferential vertebral level, position and plane of deformation with increasing scoliotic severity. Twenty-seven adolescent idiopathic scoliotic girls with mild to moderate Cobb angles (10° to 50°) participated in this study. All subjects had at least one set of bi-planar radiographs taken with the EOS® X-ray imaging system prior to any treatment. Subjects were divided into two groups, separating the mild (under 20°) from the moderate (20° and over) spinal scoliotic deformities. Wedging was calculated in three different geometric planes with respect to the smallest edge of the vertebral body. Factorial analyses of variance revealed a main effect for the scoliosis severity but no main effect of vertebral Levels (apex and each of the three vertebrae above and below it) (F = 1.78, p = 0.101). Main effects of vertebral Positions (apex and above or below it) (F = 4.20, p = 0.015) and wedging Planes (F = 34.36, p<0.001) were also noted. Post-hoc analysis demonstrated a greater wedging in the inferior group of vertebrae (3.6°) than the superior group (2.9°, p = 0.019) and a significantly greater wedging (p≤0.03) along the sagittal plane (4.3°). Vertebral wedging was present in mild scoliosis and increased as the scoliosis progressed. The greater wedging of the inferior group of vertebrae could be important in estimating the most distal vertebral segment to be restrained by bracing or to be fused in surgery. Largest vertebral body wedging values obtained in the sagittal plane support the claim that scoliosis could be initiated through a hypokyphosis.
    PLoS ONE 08/2013; 8(8):e71504. DOI:10.1371/journal.pone.0071504 · 3.53 Impact Factor
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    ABSTRACT: Abnormal longitudinal growth has been identified in the early pubertal stage of idiopathic scoliosis (IS) and is thought to contribute to the development of scoliosis. This phenotype may be caused by abnormal endochondral ossification, but histological evidence is lacking. The aim of this study was to investigate whether there is abnormal endochondral ossification in IS patients at early stage of puberty by histomorphometric analysis of their iliac cartilage. Fifty-two patients with IS and 19 controls were recruited and grouped according to their Risser grade (Group A: Risser grade 0 with Oxford stage 2-3; Group B: Risser grade 2). Group A consisted of 20 IS patients (mean age: 12.3 years) and 9 controls (mean age: 12.0 years), while Group B included 32 IS patients (mean age: 13.8 years) and 10 controls (mean age: 13.7 years). Biopsies of the iliac cartilage were harvested intra-operatively and prepared using routine histological methods. Histomorphometric analysis was performed to quantify the thickness of the hypertrophic zone, the area and number of chondrocytes in the cell-nest, and the number of chondrocytes in the proliferative zone using Image-Pro Plus software. In Group A, a significantly thicker hypertrophic zone and larger cell-nest area and number of cells within the cell-nest, and in the proliferative zone, were found in iliac cartilages from IS patients compared with those of controls (all P < 0.05). In group B however, there were no significant differences in histomorphometric parameters between IS patients and the controls. The differences in the histomorphometric results between IS patients and their controls for patients with Risser grade 0 and Oxford grades 2 & 3, but not in those with Risser grade 2, indicated a pattern of accelerated endochondral growth in IS at the early stage of puberty, but not at the late stage.Trial registration: Current Controlled Trials: ChiCTR-CCC-13003988. Registered 17 December 2013.
    BMC Musculoskeletal Disorders 12/2014; 15(1):429. DOI:10.1186/1471-2474-15-429 · 1.90 Impact Factor