The effect of the adolescent growth spurt on early posterior spinal fusion in infantile and juvenile idiopathic scoliosis

Hefti, F.; McMaster, MJ

doi:10.1302/0301-620x.65b3.6841390

Cited by 90 publications

(48 citation statements)

References 10 publications

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“…Thoracic cage size modification following spinal arthrodesis appears to be a progressive process involving multiple skeletal parameters simultaneously. In young children with progressive deformity, there is a decrease of longitudinal growth and a loss of the normal proportionality of trunk growth [5,6,10,12]. As the spinal deformity progresses by a ''domino effect'', not only spinal growth is affected, but also the size and shape of the thoracic cage are modified.…”

Section: Discussionmentioning

confidence: 99%

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Thoracic cage plasticity in prepubertal New Zealand white rabbits submitted to T1–T12 dorsal arthrodesis: computed tomography evaluation, echocardiographic assessment and cardio-pulmonary measurements

et al. 2013

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Purpose We aimed to describe the morphological changes in the thoracic cage and spinal column induced in New Zealand White (NZW) prepubertal rabbits subjected to dorsal arthrodesis and observed at skeletal maturity by computed tomography (CT) scans. This was done to evaluate the plasticity of the thoracic cage of rabbits with non-deformed spine, by highlighting its modifications after spinal arthrodesis. Emogas data analysis, echocardiographic assessment and cardio-pulmonary measurements completed the evaluation.Methods Surgery was performed in 16 female rabbits, 6 weeks old. Nine were subjected to T1-T12 dorsal arthrodesis, while seven were sham-operated. Surgery involved the implant of two C-shaped stainless steel bars and heterologous bone graft. CT scans were performed before surgery, 2, 6 and 12 months after surgery. One week after the last CT scan, echocardiographic and emogas evaluations were performed. Results Chest depth (8 %), thoracic kyphosis (ThK) (23 %), dorsal and ventral length of the thoracic spine (11 %) and sternal length (7 %) were significantly reduced in operated compared to sham-operated rabbits. Mean values ± standard deviation (SD) of PaCO 2 , PaO 2 and sO 2 were not significantly different. Mean values ± SD of echocardiographic measurements were not significantly different between the two groups of rabbits, except for thickness of the interventricular septum in systole, contractile capacity of the left ventricle and ejection fraction. Conclusions T1-T12 dorsal arthrodesis in prepubertal NZW rabbits with non-deformed spine induced changes of the thoracic cage morphology. However, those changes are source of cardio-pulmonary complications not severe enough to reproduce a clinical picture comparable to thoracic insufficiency syndrome in humans.

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Section: Discussionmentioning

confidence: 99%

“…As a ''domino effect'', the distortion of the thorax will eventually interfere with lung development and cardiac function, leading those children to develop thoracic insufficiency syndrome (TIS) [3] and cor pulmonale [1] which can be lethal in most severe cases [2,4,5,[7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Thoracic cage plasticity in prepubertal New Zealand white rabbits submitted to T1–T12 dorsal arthrodesis: computed tomography evaluation, echocardiographic assessment and cardio-pulmonary measurements

et al. 2013

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“…Methods used for evaluation of vertebral growth [18] or vertebral remodelling after spine surgery are based on measurements of distances between selected points on radiographs of the concerned vertebrae [11,12,14,17] or the disc [15,16] for indirect estimation of the vertebral growth.…”

Section: Discussionmentioning

confidence: 99%

“…It is concluded that the described method is easy to apply and has satisfactory accuracy for in vivo longitudinal studies of the volume of the vertebral body on radiographs and CT scans. strumentation and fusion [2,7,12,13,16]. The conclusion drawn from these studies are based exclusively on measurements of the vertebral height and width on radiographs, or on evaluation of certain CT scan variables [23,25,26].…”

Section: Introductionmentioning

confidence: 99%

Volumetric determination of normal and scoliotic vertebral bodies

Diab

Ollmar

Sevastik

et al. 1998

European Spine Journal

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IntroductionVertebral growth is a determining factor for the configuration of the spine in health and disease. There are several reports on vertebral growth per se [4,18] and in relation to clinical aspects of idiopathic scoliosis (IS) [19,22], in Scheuermann's disease [6,20] and in relation to the pathomechanism in experimental scoliosis [15]. There are also reports on vertebral growth asymmetry during developement of scoliosis [3,18] and still others vertebral growth after posterior spinal fusion [11,14,17] or after spinal inAbstract A new method is presented for stereological evaluation of the volume of the vertebral body in vivo. The height of the vertebral body is measured at three standardised points on an anteroposterior radiograph and at two other points on a lateral one. The area of the body is also measured using a special grid superimposed on a CT scan from the middle part of the vertebra. The volume of the vertebral body is then calculated using Cavalieri's principle for irregular objects: V = ∆a × H, where V is the volume of the vertebral body, ∆a is the mean cross-section surface area on the CT scan and H is the mean of the heights at the five points on the radiographs, computed as mean weighted circumferential height. The volume of one normal and one scoliotic vertebra was evaluated in vitro using this formula. The obtained values were compared with the values derived from serial CT scans of the two vertebrae. The results showed that the volume of the normal vertebra measured with our new method was 15.9 cm 3 and measured with serial CT scans using the same grid it was 15.07 cm 3 .For the scoliotic vertebra the values were 17.6 and 17.3 cm 3 , respectively. The degree of accuracy of the measurements with the presented method as compared with the serial CT method was 95% for the normal and 98.5% for the scoliotic vertebra. To prove the clinical applicability of the method, the heights of the apical and of the upper and the lower end vertebrae of the curve and the volume of the apical vertebrae were evaluted in eight scoliotic girls (nine curves) before and 3 years after spinal instrumentation and posterior fusion. The results showed that the mean circumferential height of the three vertebrae had increased significantly at the last follow-up. The volume of the apical vertebra had also increased, but the difference was not significant. It is concluded that the described method is easy to apply and has satisfactory accuracy for in vivo longitudinal studies of the volume of the vertebral body on radiographs and CT scans.

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“…This is certainly true with regard to sex predilection: the female-to-male ratio is 1:1 in children between three and six years of age, 2:1 to 4:1 overall in children who are at least three but less than ten years of age 5 , and 8:1 by the time the children are ten years of age, which is a ratio close to that reported for patients with adolescent idiopathic scoliosis 1 . Hefti and McMaster reported that males are normally diagnosed with juvenile idiopathic scoliosis at approximately five years of age, whereas females are diagnosed at approximately seven years of age 6 . This difference, coupled with the fact that most males become skeletally mature at a later age than females, means that the risk of curve progression is higher for males with early onset juvenile idiopathic scoliosis than for females.…”

Section: Natural History and Epidemiologymentioning

confidence: 99%

Management of Juvenile Idiopathic Scoliosis

Lenke¹,

Dobbs²

2007

The Journal of Bone and Joint Surgery-American Volume

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The effect of the adolescent growth spurt on early posterior spinal fusion in infantile and juvenile idiopathic scoliosis

Abstract: Winter RB, Moe JH. The results of spinal arthrodesis for congenital spinal deformity in patients younger than five years old.

Cited by 90 publications

References 10 publications

Thoracic cage plasticity in prepubertal New Zealand white rabbits submitted to T1–T12 dorsal arthrodesis: computed tomography evaluation, echocardiographic assessment and cardio-pulmonary measurements

Thoracic cage plasticity in prepubertal New Zealand white rabbits submitted to T1–T12 dorsal arthrodesis: computed tomography evaluation, echocardiographic assessment and cardio-pulmonary measurements

Volumetric determination of normal and scoliotic vertebral bodies

Management of Juvenile Idiopathic Scoliosis

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