The effect of growth on the correlation between the spinal and rib cage deformity: implications on idiopathic scoliosis pathogenesis

Abstract

Background: Numerous studies have attempted to quantify the correlation between the surface deformity and the Cobb angle without considering growth as an important factor that may influence this correlation. In our series, we noticed that in some younger referred children from the school-screening program there is a discrepancy between the thoracic scoliometer readings and the morphology of their spine. Namely there is a rib hump but no spinal curve and consequently no Cobb angle reading in radiographs, discrepancy which fades away in older children. Based on this observation, we hypothesized that in scoliotics the correlation between the rib cage deformity and this of the spine is weak in younger children and vice versa.

How to Improve Progress in Scoliosis Research

“…This is important because it highlights the impact of factors other than genetic make-up in developing scoliosis and has spawned the concept of epigenetics where factors other than genetics are considered to be major contributing factors (Grivas et al, 2002a(Grivas et al, , 2002b(Grivas et al, , 2006(Grivas et al, , 2007(Grivas et al, , 2008a(Grivas et al, , 2008b(Grivas et al, , 2009(Grivas et al, , 2001. Factors that might be considered must certainly include environmental conditions and their influence on spinal curve development and might present alternative treatment strategies (Hermus et al, 2007).…”

Emerging Technology and Analytical Techniques for the Clinical Assessment of Scoliosis

“…These observations have founded considerable interest to explore their utility in school screening programs [49][50][51], and clinically for the purpose of optimizing the number of x-rays [13,[54][55][56]. There is an increased understanding that the limitations that exist with the application of these surface metrics are associated with inherent variability across children that are associated with growth [48], location of the deformity [34] and treatment [52]. Notably, recent work has highlighted a stronger correlation between surface metrics and spinal curvature in older children vs younger children [48].…”

Thoracic changes and exercise capacity in patients with adolescent idiopathic scoliosis

“…Scoliosis is a three-dimensional deformity of the spine, with lateral curvature and vertebral rotation, which causes thoracic structures asymmetry [1,2]. The idiopathic form constitutes about 90% of all cases of scoliosis, the most common affects adolescents, which prevails in females with right upper thoracic curvature [3 -5].…”