Osteopenia in adolescent idiopathic scoliosis: a histomorphometric study.

STUDY DESIGN Bone biopsies from iliac crest and spinous process of adolescent idiopathic scoliosis patients were obtained intraoperatively for histology and histomorphometric analysis. OBJECTIVES To study the histologic features of cancellous bone and to correlate the histomorphometric variables with preoperative bone mineral density in patients with adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA Low bone mineral density has been reported in adolescent idiopathic scoliosis. However, there is limited information about the histopathologic changes. METHODS Undecalcified and decalcified bone specimens from iliac crest and spinous process of adolescent idiopathic scoliosis patients obtained intraoperatively were stained with Goldner and hematoxylin & eosin stain, respectively. Results were correlated with bone mineral density of the lumbar spine (L2-L4) and proximal femur measured before surgery. RESULTS Bone histology showed significant less osteocyte count in the trabecular bone characterized with smooth and continuous borders in patients with adolescent idiopathic scoliosis. Histomorphometry confirmed the lower static parameters. The results correlated well with the decreased bone mineral density. CONCLUSION Bone biopsy study suggested disturbance of bone turnover in patients with adolescent idiopathic scoliosis. The abnormal metabolism might contribute to the low bone mineral density and play an important role in the etiology and pathogenesis of adolescent idiopathic scoliosis.

[1]  F. C. Sherman,et al.  Osteoporosis and Acquired Back Deformities , 1982, Journal of pediatric orthopedics.

[2]  J. Cheng,et al.  Osteopenia in Adolescent Idiopathic Scoliosis: A Primary Problem or Secondary to the Spinal Deformity? , 1997, Spine.

[3]  B. Dawson-Hughes,et al.  Heritable and life‐style determinants of bone mineral density , 1993, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[4]  W. Goodman,et al.  Bone disease in children and adolescents undergoing successful renal transplantation. , 1998, Kidney international.

[5]  L. Qin,et al.  Generalized Low Areal and Volumetric Bone Mineral Density in Adolescent Idiopathic Scoliosis , 2000, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[6]  R. Dickson,et al.  Stature and idiopathic scoliosis. A prospective study. , 1985, The Journal of bone and joint surgery. British volume.

[7]  V. Sahgal,et al.  Morphologic and morphometric studies of muscle in idiopathic scoliosis. , 1983, Acta orthopaedica Scandinavica.

[8]  T. Illés,et al.  Persistent osteopenia in adolescent idiopathic scoliosis: a longitudinal follow-up study. , 2000, Spine.

[9]  S. Cook,et al.  Trabecular Bone Mineral Density in Idiopathic Scoliosis , 1987, Journal of pediatric orthopedics.

[10]  J. R. Bowen,et al.  Normative data for iliac bone histomorphometry in growing children. , 1992, Bone.

[11]  A. Carr,et al.  Adolescent idiopathic scoliosis in identical twins. , 1990, The Journal of bone and joint surgery. British volume.

[12]  Thoru Yamada,et al.  Melatonin: A Possible Role in Pathogenesis of Adolescent Idiopathic Scoliosis , 1996, Spine.

[13]  G. Picetti,et al.  Bone mineral in the radius and vertebral osteoporosis in an insured population. A correlative study using 125-I photon absorption and miniature roentgenography. , 1973, The Journal of bone and joint surgery. American volume.

[14]  J. Healey,et al.  Peak Skeletal Mass Assessment in Young Adults with Idiopathic Scoliosis , 1989, Spine.

[15]  H. Moriya,et al.  Structural Scoliosis Model in Dogs With Experimentally Induced Syringomyelia , 1997, Spine.

[16]  J. Cheng,et al.  Persistent osteopenia in adolescent idiopathic scoliosis. A longitudinal follow up study. , 1999, Spine.

[17]  A. Freemont,et al.  Age related histomorphometric changes in bone in normal British men and women. , 1994, Journal of clinical pathology.

[18]  W. Enneking,et al.  Pathological changes in scoliosis. , 1969, The Journal of bone and joint surgery. American volume.

[19]  S. Weinstein,et al.  Infantile and juvenile scoliosis. , 1999, The Orthopedic clinics of North America.

[20]  S. Cook,et al.  Lumbar Spine and Femoral Neck Bone Mineral Density in Idiopathic Scoliosis: A Follow‐up Study , 1992, Journal of pediatric orthopedics.

[21]  R. Dickson,et al.  The anatomy of spinal deformity: a biomechanical analysis. , 1987, Orthopedics.

[22]  J. Eisman,et al.  Sex differences in peak adult bone mineral density , 1990, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[23]  J. Miller,et al.  Serum somatomedin A and non-dialyzable urinary hydroxyproline in girls with idiopathic scoliosis. , 1981, Acta orthopaedica Scandinavica.

[24]  M. Drezner,et al.  Bone histomorphometry: Standardization of nomenclature, symbols, and units: Report of the asbmr histomorphometry nomenclature committee , 1987, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[25]  Macewen Gd,et al.  Genetic aspects of idiopathic scoliosis. A Nicholas Andry Award essay, 1970. , 1972 .

[26]  R. Wynne‐Davies.  Familial (idiopathic) scoliosis. A family survey. , 1968, The Journal of bone and joint surgery. British volume.

[27]  N. Samaan,et al.  Growth hormone blood levels in patients with idiopathic scoliosis. , 1971, Clinical orthopaedics and related research.

[28]  J. Taylor,et al.  Scoliosis and growth. Patterns of asymmetry in normal vertebral growth. , 1983, Acta orthopaedica Scandinavica.

[29]  J. Miller,et al.  Growth related hormones in idiopathic scoliosis. An endocrine basis for accelerated growth. , 1980, Acta orthopaedica Scandinavica.