RESUMEN
STUDY DESIGN: Morphometric analysis of vertebrae from normal patients and patients with adolescent idiopathic scoliosis. OBJECTIVES: To use magnetic resonance imaging to assess pedicle asymmetry in normal patients and patients with adolescent idiopathic scoliosis in the early stages of scoliosis development and to determine if patients with adolescent idiopathic scoliosis exhibited a consistent vertebral morphology. SUMMARY OF BACKGROUND DATA: To date, most studies of vertebral morphology in adolescent idiopathic scoliosis have produced conflicting data, especially on pedicle length, and have been conducted on patients in the late stages of scoliosis development, which may affect the patterns of vertebral morphology detected. Magnetic resonance imaging enables in vivo assessment of curves during development and permits improved acquisition of transverse images. METHODS: Magnetic resonance images of 76 pedicles from 8 normal patients and 80 pedicles from 10 patients with adolescent idiopathic scoliosis were examined retrospectively. Recorded parameters included pedicle lengths, pedicle widths, pedicle areas, pedicle perimeters, and lamina lengths. The extent and direction of asymmetry in vertebrae from normal patients and patients with adolescent idiopathic scoliosis were determined and compared. RESULTS: Normal patients displayed significant neural arch asymmetry, with the left sided measurements being greater. Patients with adolescent idiopathic scoliosis also displayed significant neural arch asymmetry; however, the longer pedicle was not consistently on the convexity or the concavity. CONCLUSIONS: The baseline used to assess adolescent idiopathic scoliosis vertebral morphology must take into consideration the extent and direction of normal vertebral asymmetry. The pattern of vertebral asymmetry seen inadolescent idiopathic scoliosis may depend on the specific cause of the disorder, with no consistent pattern evident when data from different causes are pooled together.
Asunto(s)
Imagen por Resonancia Magnética , Escoliosis/diagnóstico , Columna Vertebral/anomalías , Columna Vertebral/patología , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética/estadística & datos numéricos , Masculino , Variaciones Dependientes del Observador , Valores de Referencia , Estudios Retrospectivos , Escoliosis/patología , Columna Vertebral/anatomía & histologíaRESUMEN
BACKGROUND AND OBJECTIVES: The neurocentral synchondrosis (NCS) is a cartilaginous growth plate that since the early 1900s has been implicated as a potential cause of adolescent idiopathic scoliosis (AIS). Previous studies have focused only on the closure age without characterizing normal NCS development. Using MRI, the normal development of the NCS image can be characterized, and the stages preceding the disappearance of this image can be specified. METHODS: A total of 405 NCSs were visualized in 11 normal pediatric patients using T1 and T2 transverse and sagittal MRI views. The images were correlated and the variety of images recorded to categorize the NCS into developmental stages. RESULTS: The development of the NCS was categorized into five developmental stages. The image of the NCS became absent in a specific pattern along the vertebral column, first in the cervical region (age 6), then in the lumbar region (age 12), and finally in the thoracic region (age 14). CONCLUSION: The normal development of the NCS at the level of individual vertebrae and also along the vertebral column as a whole was determined using MRI. These patterns of development are valuable and necessary to evaluate the role of the NCS in pathological conditions.
Asunto(s)
Cartílago Articular/anatomía & histología , Placa de Crecimiento/anatomía & histología , Imagen por Resonancia Magnética , Vértebras Torácicas/anatomía & histología , Adolescente , Desarrollo Óseo/fisiología , Cartílago Articular/crecimiento & desarrollo , Distribución de Chi-Cuadrado , Niño , Preescolar , Femenino , Placa de Crecimiento/fisiología , Humanos , Lactante , Masculino , Estudios Retrospectivos , Escoliosis/diagnóstico , Vértebras Torácicas/crecimiento & desarrolloRESUMEN
The neurocentral junction (NCJ) is a cartilaginous growth plate in the vertebra that has been implicated as a potential cause of adolescent idiopathic scoliosis (AIS) since the early 1900s. Studies to date have focused on the age of closure without characterizing normal NCJ development. Using MRI, the normal development of the NCJ image can be determined and the stages preceding the disappearance of the NCJ image can be characterized. 405 NCJs from 11 pediatric patients were examined using MRI and the various images were categorized. NCJ development encompassed five stages, with a specific pattern of absence of the NCJ image noted in each vertebra and in the vertebral column as a whole. The image of the NCJ first became absent in the cervical region (age 6), then in the lumbar region (age 12) and finally in the thoracic region (age 14). These patterns of development serve as a baseline to evaluate NCJ pathology in conditions such as adolescent idiopathic scoliosis (AIS).
Asunto(s)
Desarrollo Óseo/fisiología , Placa de Crecimiento/patología , Vértebras Lumbares/patología , Imagen por Resonancia Magnética , Vértebras Torácicas/patología , Adolescente , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , MasculinoRESUMEN
The neurocentral junction (NCJ) is a cartilaginous growth plate located between the vertebral centrurn and the neural arch. In characterizing the age of closure of this growth plate, anatomic studies have suggested that the NCJ closes before age 10, whereas MRI studies have suggested that the NCJ does not fuse until adolescence In this study, gross anatomic and histologic sections were correlated with MR images to determine the components of the NCJ image. The NCJ image appeared as a thick white line that was shown to encompass the cartilage of the growth plate, the surrounding woven bone and a portion of the trabecular bone of the vertebra. Although the MR pixels were too large to completely resolve the tissues that surround the growth plate, MRI was shown to be a valuable technique of visualizing the NCJ cartilage and further MRI studies of the human NCJ are needed.