What is relative anterior spinal overgrowth of the adolescent idiopathic scoliotic spine?
Refereed conference paper presented and published in conference proceedings

One of the often reported observations in adolescent idiopathic scoliosis (AIS) is that the thoracic spine is longer anteriorly than posteriorly, most pronounced around the apex and the discs contribute more than the vertebral bodies. This so called relative anterior spinal overgrowth, or RASO, has been suggested as part of the etiologic mechanism of AIS. However, the role of the posterior spinal column and the lamina has so far not been elucidated, and, therefore, it remained unclear whether this anterior-posterior length discrepancy is the result of relative anterior lengthening
or relative posterior shortening.

To define the discrepancy of the three-dimensional CT measured anterior-posterior length of the spinal column in idiopathic scoliosis versus controls.

IRB approval and patient consent was obtained. Consecutive series of high-resolution pre-operative CT scans of 80 moderate to severe AIS patients (Cobb angle: 46-109°) and scans of 30 non-scoliotic agematched controls were analyzed. The height of the anterior and posterior vertebral bodies and discs, as well as the height of the laminae,
interlaminar spaces, spinous processes and interspinous spaces of the thoracic curve, and corresponding levels in controls, were measured semi-automatically in the true mid sagittal plane of each individual vertebra.

Results and discussions
In AIS, the anterior height of the vertebral bodies and discs of the thoracic curve was 3.6±2.8% longer as compared to the posterior height, 2.0±6.1% longer than the length along the laminae and 8.7±7.1% longer than the length along the spinous processes and differed from controls (controls: -2.7±2.4%, -7.4±5.2% and +0.7±7.8%; p<0.001), with the non-osseous structures contributing significantly more to the length discrepancies. In absolute lengths, the anterior side of the disc of the thoracic curve was higher in AIS (5.4±0.8 mm) than controls (4.8±1.0 mm; p<0.001), whereas the interspinous space was smaller in AIS (12.3±1.4 mm versus 14.0±1.6 mm; p<0.001) and the absolute lengths of the osseous parts differed not significantly between AIS and controls.

Conclusions and significance
The true three-dimensional anterior-posterior length discrepancy of the scoliotic thoracic curves occur through both anterior column lengthening as well as posterior column shortening, with the facet joints as the fulcrum. In moderate to severe AIS, the vertebral bodies contribute partly to the anterior-posterior length discrepancy accompanied by more significant and possibly secondary increased anterior intervertebral discs height.
著者Rob C. Brink, Tom P.C. Schlösser, Marijn van Stralen, Koen L. Vincken, Moyo C. Kruyt, Steve C.N. Hui, Max A. Viergever, Winnie C.W. Chu, Jack C.Y. Cheng, René M. Castelein
會議名稱The 12th Meeting of International Research Society of Spinal Deformities (IRSSD)
會議論文集題名Scoliosis and Spinal Disorders
期次Supp 1
頁次1 - 2

上次更新時間 2018-16-11 於 15:18