Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, 5/F, Clinical Science Building, Shatin, NT, Hong Kong SAR, China.
Eur Spine J. 2010 May;19(5):726-31. doi: 10.1007/s00586-009-1247-7. Epub 2010 Jan 3.
Abnormal anthropometric measurements during the peripubertal growth spurt have been documented in adolescent idiopathic scoliosis (AIS). Magnetic resonance (MR) imaging studies of the spine have suggested a disproportionate endochondral and membranous ossification in AIS. The present study aimed at investigating whether disproportional ossification and skeletal growth occurred in the peripheral bone of AIS patients using the radius as the target bone. Skeletally mature AIS girls with different severity (n = 290) and age-matched control healthy girls (n = 80) were recruited. The anthropometric parameters were recorded. The midshaft of non-dominant radius was scanned with peripheral quantitative computed tomography (pQCT) and the radius diameter was calculated from the cross-sectional area. Radius dimension ratio was derived from the ratio of radius diameter to radius length. The anthropometric parameters were compared between AIS and control with adjustment for age. The radius dimension ratio was further correlated with curve severity in AIS girls using Pearson's correlation test. The analysis showed that the arm span and radius length were slightly longer in AIS girls. The BMI of AIS girls was significantly lower than the controls. The radius dimension ratio in severe AIS girls was significantly lower than the controls and the ratio of AIS girls correlated with the curve severity (r = -0.120; p = 0.039). The abnormal radius dimension ratio supported the presence of systemic growth abnormalities in AIS. Disproportional endochondral-membranous ossification could explain for the observation. The observation of the association of radius dimension ratio with curve severity provides an important potentially clinically measurable parameter for further longitudinal studies on the prognostication of curve progression in AIS.
在青春期生长突增期间，已经记录到青少年特发性脊柱侧凸（AIS）患者的异常人体测量学测量值。脊柱磁共振（MR）成像研究表明，AIS 存在不成比例的骺软骨和膜内成骨。本研究旨在通过以桡骨为靶骨，研究 AIS 患者外周骨是否存在不成比例的骨化和骨骼生长。招募了不同严重程度（n=290）和年龄匹配的健康对照组（n=80）的骨骼成熟 AIS 女孩。记录了人体测量学参数。用外周定量 CT（pQCT）扫描非优势侧桡骨中段，并根据横截面积计算桡骨直径。从桡骨直径与桡骨长度的比值得出桡骨尺寸比。在调整年龄后，比较 AIS 和对照组之间的人体测量学参数。使用 Pearson 相关检验进一步分析 AIS 女孩的桡骨尺寸比与曲线严重程度的相关性。分析显示，AIS 女孩的臂展和桡骨长度略长。AIS 女孩的 BMI 明显低于对照组。严重 AIS 女孩的桡骨尺寸比明显低于对照组，并且 AIS 女孩的比值与曲线严重程度相关（r=-0.120；p=0.039）。异常的桡骨尺寸比支持 AIS 存在全身生长异常。不成比例的骺软骨-膜内成骨可以解释这一观察结果。桡骨尺寸比与曲线严重程度之间的关联观察为进一步研究 AIS 曲线进展的预后提供了一个重要的潜在临床可测量参数。
