SH Ho Scoliosis Research Laboratory, Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong, China; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Institute for Biomechanics, ETH Zurich, Zurich, Switzerland.
Bone. 2023 Jan;166:116594. doi: 10.1016/j.bone.2022.116594. Epub 2022 Oct 28.
Abnormal osteocyte lacunar morphology in adolescent idiopathic scoliosis (AIS) has been reported while the results were limited by the number of osteocyte lacunae being quantified. The present study aimed to validate previous findings through (a) comparing morphological features of osteocyte lacunae between AIS patients and controls in spine and ilium using a large-scale assessment, and (b) investigating whether there is an association between the acquired morphological features of osteocyte lacunae and disease severity in AIS.
Trabecular bone tissue of the facet joint of human vertebrae on both concave and convex sides at the apex of the scoliotic curve were collected from 4 AIS and 5 congenital scoliosis (CS) patients, and also at the same anatomic site from 3 non-scoliosis (NS) subjects intraoperatively. Trabecular bone tissue from ilium was obtained from 12 AIS vs 9 NS subjects during surgery. Osteocyte lacunae were assessed using ultra-high-resolution micro-computed tomography. Clinical information such as age, body mass index (BMI) and radiological Cobb angle of the major curve were collected.
There was no significant difference between density of osteocyte lacuna and bone volume fraction (BV/TV) between groups. A total of 230,076 and 78,758 osteocyte lacunae from facet joints of apical vertebra of scoliotic curve and iliac bone were included in the analysis, respectively. In facet joint bone biopsies, lacunar stretch (Lc.St) was higher, and lacunar equancy (Lc.Eq), lacunar oblateness (Lc.Ob), and lacunar sphericity (Lc.Sr) were lower in AIS and CS groups when compared with NS group. CA side was associated with higher Lc.St when compared with CX side. In iliac bone biopsies, Lc.Ob was higher and lacunar surface area (Lc.S) was lower in AIS group than NS group. Median values of Lc.St, Lc.Eq and Lc.Sr were significantly associated with radiological Cobb angle with adjustment for age and BMI (R-squared: 0.576, 0.558 and 0.543, respectively).
This large-scale assessment of osteocyte lacunae confirms that AIS osteocyte lacunae are more oblate in iliac bone that is less influenced by asymmetric loading of the deformed spine than the vertebrae. Shape of osteocyte lacunae in iliac bone is associated with radiological Cobb angle of the major curve in AIS patients, suggesting the likelihood of systemic abnormal osteocyte morphology in AIS. Osteocyte lacunae from concave side of scoliotic curves were more stretched in both AIS and CS groups, which is likely secondary to asymmetric mechanical loading.
研究报道称,青少年特发性脊柱侧凸(AIS)患者的成骨细胞陷窝形态异常,但其数量有限。本研究旨在通过(a)使用大规模评估比较 AIS 患者和对照组脊柱和髂骨成骨细胞陷窝的形态特征,(b)研究成骨细胞陷窝获得的形态特征与 AIS 疾病严重程度之间的关系,验证以前的发现。
收集 4 例 AIS 和 5 例先天性脊柱侧凸(CS)患者脊柱侧凸曲度顶点凹侧和凸侧关节突的小梁骨组织,以及 3 例非脊柱侧凸(NS)患者的同一解剖部位术中骨组织;收集 12 例 AIS 和 9 例 NS 患者手术时髂骨的小梁骨组织。使用超高分辨率微计算机断层扫描评估成骨细胞陷窝。收集年龄、体重指数(BMI)和主要曲线放射学 Cobb 角等临床信息。
各组间成骨细胞陷窝密度和骨体积分数(BV/TV)无显著差异。共纳入脊柱侧凸曲度顶点关节突和髂骨小梁骨组织的 230076 个和 78758 个成骨细胞陷窝。在关节突骨活检中,与 NS 组相比,AIS 和 CS 组的陷窝拉伸(Lc.St)较高,陷窝均质性(Lc.Eq)、陷窝扁度(Lc.Ob)和陷窝球形度(Lc.Sr)较低。与 CX 侧相比,CA 侧的 Lc.St 更高。在髂骨活检中,与 NS 组相比,AIS 组的 Lc.Ob 较高,陷窝表面积(Lc.S)较低。经年龄和 BMI 校正后,Lc.St、Lc.Eq 和 Lc.Sr 的中位数与放射学 Cobb 角显著相关(R 平方:0.576、0.558 和 0.543)。
本研究对成骨细胞陷窝进行了大规模评估,证实 AIS 患者的成骨细胞陷窝在髂骨中更扁,这是由于变形脊柱的不对称负荷对其影响较小,而不是由不对称负荷引起的。AIS 患者的主要曲线放射学 Cobb 角与成骨细胞陷窝的形状有关,这表明 AIS 患者可能存在全身异常成骨细胞形态。AIS 和 CS 组脊柱侧凸曲度凹侧的成骨细胞陷窝拉伸程度更大,这可能是由于不对称机械负荷所致。