Biomechanical analysis and modeling of different vertebral growth patterns in adolescent idiopathic scoliosis and healthy subjects

Scoliosis

Carl-Eric Aubin¹  Jack CY Cheng³  Winnie CW Chu²  Isabelle Villemure¹  Mark Driscoll¹  Defeng Wang¹  Lin Shi¹ 

[1] Research Center, Sainte-Justine University Hospital Center, 3175 Cote Sainte-Catherine Road, Montréal, QC H3T 1C5, Canada;Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, N.T., Hong Kong;Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, N.T., Hong Kong

关键词: scoliosis pathomechanism;    bone growth modulation;    adolescent idiopathic scoliosis;    growth profile of the vertebral body;    finite element model;   

Others  :  793206
DOI  :  10.1186/1748-7161-6-11

 received in 2011-03-11, accepted in 2011-05-23,  发布年份 2011

【 摘 要 】

Background

The etiology of AIS remains unclear, thus various hypotheses concerning its pathomechanism have been proposed. To date, biomechanical modeling has not been used to thoroughly study the influence of the abnormal growth profile (i.e., the growth rate of the vertebral body during the growth period) on the pathomechanism of curve progression in AIS. This study investigated the hypothesis that AIS progression is associated with the abnormal growth profiles of the anterior column of the spine.

Methods

A finite element model of the spinal column including growth dynamics was utilized. The initial geometric models were constructed from the bi-planar radiographs of a normal subject. Based on this model, five other geometric models were generated to emulate different coronal and sagittal curves. The detailed modeling integrated vertebral body growth plates and growth modulation spinal biomechanics. Ten years of spinal growth was simulated using AIS and normal growth profiles. Sequential measures of spinal alignments were compared.

Results

(1) Given the initial lateral deformity, the AIS growth profile induced a significant Cobb angle increase, which was roughly between three to five times larger compared to measures utilizing a normal growth profile. (2) Lateral deformities were absent in the models containing no initial coronal curvature. (3) The presence of a smaller kyphosis did not produce an increase lateral deformity on its own. (4) Significant reduction of the kyphosis was found in simulation results of AIS but not when using the growth profile of normal subjects.

Conclusion

Results from this analysis suggest that accelerated growth profiles may encourage supplementary scoliotic progression and, thus, may pose as a progressive risk factor.

【 授权许可】

   
2011 Shi et al; licensee BioMed Central Ltd.

【 图 表 】

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