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

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

doi:10.1016/j.jot.2018.12.001

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

J Orthop Translat. 2019 Jan 7:17:103-111. doi: 10.1016/j.jot.2018.12.001. eCollection 2019 Apr.

Authors

Bo Chen^{1

2}, Qiaoyan Tan¹, Hangang Chen¹, Fengtao Luo¹, Meng Xu¹, Jianhua Zhao², Peng Liu², Xianding Sun¹, Nan Su¹, Dali Zhang¹, Weili Fan², Mingyong Liu², Haiyang Huang², Zuqiang Wang¹, Junlan Huang¹, Ruobin Zhang¹, Can Li¹, Fangfang Li¹, Zhenhong Ni¹, Xiaolan Du¹, Min Jin¹, Jing Yang¹, Yangli Xie¹, Lin Chen¹

Affiliations

¹ 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.
² Department of Spine Surgery, Institute of Surgery Research, Daping Hospital, Army Medical University, Chongqing, 400042, China.

Abstract

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.