Morphometric Analysis of Thoracic and Lumbar Vertebrae in Idiopathic Scoliosis

Liljenqvist, Ulf; Link, Thomas M.; Halm, H.

doi:10.1097/00007632-200005150-00008

Cited by 188 publications

(154 citation statements)

References 28 publications

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“…Because the clinical definition of scoliosis as a lateral curve with a Cobb angle > 10° is not applicable to a palaeoanthropological context, the present study uses a morphometric approach similar to that of Liljenqvist et al (2000) and Parent et al (2002;2004a, b) to evaluate the rotational deformity of scoliotic vertebrae. Our results confirm that scoliotic spines can be distinguished from non-scoliotic vertebral columns by a combination of different asymmetries of the individual vertebrae that increase towards the apex of the curve, but are absent at the neutral vertebra.…”

Section: Discussionmentioning

confidence: 99%

“…1). Morphometric studies further demonstrated a decreased pedicular width on the concavity of the curve, increased lateral wedging of the vertebral bodies towards the apex of the curve, and facet surface asymmetries (Liljenqvist et al, 2000;Parent et al, 2002;Parent et al, 2004b).…”

Section: Scoliosismentioning

confidence: 94%

“…In accordance to the variables analyzed by Liljenqvist et al (2000) and Parent et al (2002;2004b), 35 3D-landmarks per vertebra were recorded by one of us (R.S.) using a MicroScribe G2 (Immersion Corporation, San José, CA, USA; Fig.…”

Section: Data Acquisitionmentioning

confidence: 99%

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Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Schiess¹,

Boeni²,

Rühli³

et al. 2014

Journal of Human Evolution

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Owing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding skeletal biology of Homo erectus. Nevertheless, since Latimer and Ohman (2001, Axial dysplasia in Homo erectus. J Hum Evol 40:A12) reported on asymmetries and distortions of Nariokotome boy's axial skeleton suggesting adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as reference for Homo erectus. Recently, however, the presence of skeletal dysplasia has been refuted. Here, we present a morphologic and morphometric reanalysis of the assertion of idiopathic scoliosis. We demonstrate that unarticulated vertebral columns of non-scoliotic and scoliotic individuals can be distinguished based on the lateral deviation of the spinous process, lateral and sagittal wedging, vertebral body torsion, pedicle thickness asymmetry and asymmetry of the superior and inferior articular facet area. A principal component analysis of the overall asymmetry of all seven vertebral shape variables groups KNM-WT 15000 within non-scoliotic modern humans. An anomaly of vertebrae T1-T2 is compatible with a short left convex curve at the uppermost thoracic region, possibly due to injury or local growth dysbalance. Asymmetries of the facet joints L3-L5 suggest a local right convex curve in the lower lumbar region that probably resulted from juvenile traumatic disc herniation. This pattern is incompatible with adolescent idiopathic scoliosis or other types of scoliosis, including congenital, neuromuscular or syndromic scoliosis. It is, however, consistent with a recent reanalysis of the rib cage that did not reveal any asymmetry. Except for these possibly trauma-related anomalies, the Nariokotome boy fossil therefore seems to belong to a normal Homo erectus youth without evidence for adolescent idiopathic scoliosis or other severe pathologies of the axial skeleton. AbstractOwing to its completeness, the 1.5 million year old Nariokotome boy skeleton KNM-WT 15000 is central for understanding skeletal biology of Homo erectus. Nevertheless, since Latimer and Ohman (2001, Axial dysplasia in Homo erectus. J Hum Evol 40:A12) reported on asymmetries and distortions of Nariokotome boy's axial skeleton suggesting adolescent idiopathic scoliosis, possibly associated with congenital skeletal dysplasia, it is questionable whether it still can be used as reference for Homo erectus. Recently, however, the presence of skeletal dysplasia has been refuted. Here, we present a morphologic and morphometric reanalysis of the assertion of idiopathic scoliosis. We demonstrate that unarticulated vertebral columns of non-scoliotic and scoliotic individuals can be distinguished based on the lateral deviation of the spinous process, lateral and sagittal wedging, vertebral body torsion, pedicle thickness asymmetry and asymmetry of the superior and inferior articular facet area. A principal component analysis of the overall asymmetry of all seven vertebral shap...

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Section: Discussionmentioning

confidence: 99%

Section: Scoliosismentioning

confidence: 94%

See 1 more Smart Citation

Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Schiess¹,

Boeni²,

Rühli³

et al. 2014

Journal of Human Evolution

View full text Add to dashboard Cite

show abstract

“…Pedicle screw fixation can be dangerous because of the maximum permissible translational error of less than 1 mm and rotational error of less than 5° [16] in the scoliotic spine, especially the mid-thoracic spine because of the small pedicle diameter, limited space between the spinal cord and the medial pedicle, and the morphological deformity of the pedicle [17]. A freehand thoracic pedicle screw insertion technique with no radiographic guidance or intraoperative tracking devices has been reported to be safe and reliable [15].…”

Section: Discussionmentioning

confidence: 99%

Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis

Zhang²,

Peng

et al. 2011

Eur Spine J

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Objective To determine the ideal entry point for individual pedicle screw in the surgical treatment of idiopathic scoliosis using computed tomographic (CT) three-dimensional (3D) reconstruction. Methods Twenty patients with moderate or severe idiopathic scoliosis from two groups received surgical treatment using ''Free Hand technique'' and ''Assisted Free Hand technique''. Computed tomographic scanning with 3D reconstruction of the thoracic and lumbar spine was conducted to determine the entry point and to evaluate the placement accuracy. Results The accuracy of placement was 88.2% in convexity and 84.5% in concavity for the ''Free Hand'' group, and 94.1% in convexity and 94% in concavity for the ''Assisted Free Hand'' group. Evidence showed that ''Assisted Free Hand'' group had higher accuracy when screws were placed in the thoracic spine (P = 0.02), while no obvious difference was seen in the lumbar spine placement (P = 0.47). Conclusions We conclude that in the surgical treatment of severe scoliosis, individual screw placement guided by entry points determined by CT reconstruction can result in improved accuracy and ease of the procedure.

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“…The anatomies of vertebrae and pedicle are also distorted in patients with neuromuscular scoliosis like idiopathic scoliosis [28,43]. Pedicle screw fixation in such patients is difficult, so accurate and safe placement is mandatory to achieve the fixation [33].…”

Section: Introductionmentioning

confidence: 99%

Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique

et al. 2008

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It is a retrospective analytic study of 1,009 transpedicular screws (689 thoracic and 320 lumbosacral), inserted with free-hand technique in neuromuscular scoliosis using postoperative CT scan. The aim of paper was to determine the accuracy and safety of transpedicular screw placement with free-hand technique in neuromuscular scoliosis and to compare the accuracy at different levels in such population. All studies regarding accuracy and safety of pedicle screw in scoliosis represent idiopathic scoliosis using various techniques such as free-hand, navigation, image intensifier, etc., for screw insertion. Anatomies of vertebrae and pedicle are distorted in scoliosis, hence accurate and safe placement of pedicle screw is prerequisite for surgery. Between 2004 and 2006, 37 consecutive patients, average age 20 years (9-44 years), of neuromuscular scoliosis were operated with posterior pedicle screw fixation using free-hand technique. Accuracy of pedicle screws was studied on postoperative CT scan. Placement up to 2 mm medial side and 4 mm lateral side was considered within-safe zone. Of the 1,009 screws, 273 screws were displaced medially, laterally or on the anterior side showing that 73% screws (68% in thoracic and 82.5% in lumbar spine) were accurately placed within pedicle. Considering the safe zone, 93.3% (942/1009, 92.4% in thoracic and 95.3% in lumbar spine) of the screws were within the safe zone. Comparing accuracy according to severity of curve, accuracy was 75% in group 1 (curve \90°) and 69% in group 2 (curve [90°) with a safety of 94.8 and 91.2%, respectively (P = 0.35). Comparing the accuracy at different thoracic levels, it showed 67, 64 and 72% accuracy in upper, middle and lower thoracic levels with safety of 96.6, 89.2 and 93.1%, respectively, exhibiting no statistical significant difference (P = 0.17). Pedicle screw placement in neuromuscular scoliosis with free-hand technique is accurate and safe as other conditions.

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Morphometric Analysis of Thoracic and Lumbar Vertebrae in Idiopathic Scoliosis

Cited by 188 publications

References 28 publications

Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Revisiting scoliosis in the KNM-WT 15000 Homo erectus skeleton

Use of computed tomographic reconstruction to establish the ideal entry point for pedicle screws in idiopathic scoliosis

Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique

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