Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis

Objective: Scoliosis is a common disease characterized by spinal curvature with variable severities. There is no generally accepted theory about the physical origin of the spinal deformation of scoliosis. The aim of this study was to explore a new hypothesis suggesting that the curvatures in scolios...

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Main Authors: Bo Chen, Qiaoyan Tan, Hangang Chen, Fengtao Luo, Meng Xu, Jianhua Zhao, Peng Liu, Xianding Sun, Nan Su, Dali Zhang, Weili Fan, Mingyong Liu, Haiyang Huang, Zuqiang Wang, Junlan Huang, Ruobin Zhang, Can Li, Fangfang Li, Zhenhong Ni, Xiaolan Du, Min Jin, Jing Yang, Yangli Xie, Lin Chen
Format: Article
Language:English
Published: Elsevier 2019-04-01
Series:Journal of Orthopaedic Translation
Online Access:http://www.sciencedirect.com/science/article/pii/S2214031X18301761
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author Bo Chen
Qiaoyan Tan
Hangang Chen
Fengtao Luo
Meng Xu
Jianhua Zhao
Peng Liu
Xianding Sun
Nan Su
Dali Zhang
Weili Fan
Mingyong Liu
Haiyang Huang
Zuqiang Wang
Junlan Huang
Ruobin Zhang
Can Li
Fangfang Li
Zhenhong Ni
Xiaolan Du
Min Jin
Jing Yang
Yangli Xie
Lin Chen
spellingShingle Bo Chen
Qiaoyan Tan
Hangang Chen
Fengtao Luo
Meng Xu
Jianhua Zhao
Peng Liu
Xianding Sun
Nan Su
Dali Zhang
Weili Fan
Mingyong Liu
Haiyang Huang
Zuqiang Wang
Junlan Huang
Ruobin Zhang
Can Li
Fangfang Li
Zhenhong Ni
Xiaolan Du
Min Jin
Jing Yang
Yangli Xie
Lin Chen
Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
Journal of Orthopaedic Translation
author_facet Bo Chen
Qiaoyan Tan
Hangang Chen
Fengtao Luo
Meng Xu
Jianhua Zhao
Peng Liu
Xianding Sun
Nan Su
Dali Zhang
Weili Fan
Mingyong Liu
Haiyang Huang
Zuqiang Wang
Junlan Huang
Ruobin Zhang
Can Li
Fangfang Li
Zhenhong Ni
Xiaolan Du
Min Jin
Jing Yang
Yangli Xie
Lin Chen
author_sort Bo Chen
title Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
title_short Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
title_full Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
title_fullStr Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
title_full_unstemmed Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
title_sort imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosis
publisher Elsevier
series Journal of Orthopaedic Translation
issn 2214-031X
publishDate 2019-04-01
description Objective: Scoliosis is a common disease characterized by spinal curvature with variable severities. There is no generally accepted theory about the physical origin of the spinal deformation of scoliosis. The aim of this study was to explore a new hypothesis suggesting that the curvatures in scoliosis may be associated with the imbalance growth between thoracic vertebral column and sternum. Methods: We undertook a comparative computed tomography (CT) based morphology study of thoracic vertebrae and sternum of patients with adolescent idiopathic scoliosis (AIS) and age-gender matched normal subjects. We further measured the ratios between the lengths of the sternum and thoracic vertebra of mice with deficiency of fibroblast growth factor receptor 3 (FGFR3), which exhibit scoliosis. Three-week-old C57BL/6J mice were used to generate bipedal and sternal growth plate injury model. Radiographs and histological images were obtained to observe the presence of sternal and spinal deformity. Results: There was a significant correlation between the severities of scoliosis and the ratios of the sternum to thoracic vertebral lengths. We also found that FGFR3 deficient mice showed smaller ratio of the sternum to thoracic vertebra lengths than that of the wild-type mice, which were similar with that of the AIS patients. Surgery-induced injuries of sternal growth plates can accelerate and aggravate the scoliosis in bipedal mice and imbalanced development of anterior and posterior thoracic occurred before the appearance of scoliosis. Conclusions: Our findings suggest that the imbalanced growth between the thoracic vertebral column and the sternum is an important causative factor for the pathogenesis of scoliosis including AIS. The translational potential of this article: Imbalanced growth between the thoracic vertebral column and the sternum is associated with scoliosis. Surgical or rehabilitation intervention for scoliosis should focus on all components involved in the pathogenesis of curvature to obtain better outcome. Keywords: Growth plate, Imbalanced growth, Scoliosis, Sternum, Vertebrae
url http://www.sciencedirect.com/science/article/pii/S2214031X18301761
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spelling doaj-e754688612dd4390a3dc594727dbd0aa2020-11-24T21:43:12ZengElsevierJournal of Orthopaedic Translation2214-031X2019-04-0117103111Imbalanced development of anterior and posterior thorax is a causative factor triggering scoliosisBo Chen0Qiaoyan Tan1Hangang Chen2Fengtao Luo3Meng Xu4Jianhua Zhao5Peng Liu6Xianding Sun7Nan Su8Dali Zhang9Weili Fan10Mingyong Liu11Haiyang Huang12Zuqiang Wang13Junlan Huang14Ruobin Zhang15Can Li16Fangfang Li17Zhenhong Ni18Xiaolan Du19Min Jin20Jing Yang21Yangli Xie22Lin Chen23Laboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China; Department of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaDepartment of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaDepartment of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaDepartment of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaDepartment of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaDepartment of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, ChinaLaboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China; Corresponding author. Laboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.Laboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China; Corresponding author. Laboratory for the Rehabilitation of Traumatic Injuries, State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.Objective: Scoliosis is a common disease characterized by spinal curvature with variable severities. There is no generally accepted theory about the physical origin of the spinal deformation of scoliosis. The aim of this study was to explore a new hypothesis suggesting that the curvatures in scoliosis may be associated with the imbalance growth between thoracic vertebral column and sternum. Methods: We undertook a comparative computed tomography (CT) based morphology study of thoracic vertebrae and sternum of patients with adolescent idiopathic scoliosis (AIS) and age-gender matched normal subjects. We further measured the ratios between the lengths of the sternum and thoracic vertebra of mice with deficiency of fibroblast growth factor receptor 3 (FGFR3), which exhibit scoliosis. Three-week-old C57BL/6J mice were used to generate bipedal and sternal growth plate injury model. Radiographs and histological images were obtained to observe the presence of sternal and spinal deformity. Results: There was a significant correlation between the severities of scoliosis and the ratios of the sternum to thoracic vertebral lengths. We also found that FGFR3 deficient mice showed smaller ratio of the sternum to thoracic vertebra lengths than that of the wild-type mice, which were similar with that of the AIS patients. Surgery-induced injuries of sternal growth plates can accelerate and aggravate the scoliosis in bipedal mice and imbalanced development of anterior and posterior thoracic occurred before the appearance of scoliosis. Conclusions: Our findings suggest that the imbalanced growth between the thoracic vertebral column and the sternum is an important causative factor for the pathogenesis of scoliosis including AIS. The translational potential of this article: Imbalanced growth between the thoracic vertebral column and the sternum is associated with scoliosis. Surgical or rehabilitation intervention for scoliosis should focus on all components involved in the pathogenesis of curvature to obtain better outcome. Keywords: Growth plate, Imbalanced growth, Scoliosis, Sternum, Vertebraehttp://www.sciencedirect.com/science/article/pii/S2214031X18301761