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The different expression of type X collagen and Runx2 between the convex and concave side of vertebral growth plate in scoliosis may help to improve our understanding of the role that growth plate tissue play in the development or progression of idiopathic scoliosis. In this investigation, there were significant differences of the total expression of type X collagen, Runx2 protein, and Runx2 mRNA between convex side and concave side growth plates of the apex vertebrae (p0.05). The total expression of type X collagen in the concave side growth plates of the lower end vertebrae was higher than that in the same side growth plates of apex (p0.05). The total expression of Runx2 in the concave side growth plates in the upper and lower end vertebrae were higher than that in the concave side growth plates of apex (p0.05). The expression of type X collagen, Runx2, and Runx2 mRNA, the cell density of type X collagen and Runx2 positive chondrocytes, and histological changes between convex side and concave side of the vertebral growth plate indicated that the vertebral growth plate was affected by mechanical forces, which was a secondary change and could contribute to progression of adolescent idiopathic scoliosis.

Study design A correlation analysis between histologic grade (HG) of iliac crest apophysis and skeletal age assessments. Objective To study the correlation between HGs of iliac crest apophysis and the skeletal age of hand and wrist, digital skeletal age (DSA), and Risser sign in the girls with adolescent idiopathic scoliosis (AIS). Summary of background data The evaluation of the remaining growth of the patients clinically and radiologically is highly significant in predicting the curve progression and thus influencing the treatment strategy in AIS. Methods Fifty-three AIS girls with a mean age of 14.0 years undergoing corrective posterior spinal surgery and instrumentation with autogenous bone graft were recruited. Menarche status was recorded while the skeletal age of hand and wrist, DSA, and Risser grade were evaluated radiologically. Using a standardized HG of proliferative chondrocyte zone of the iliac crest apophysis, correlation between the HGs and the radiologic and clinical skeletal maturity parameters was analyzed. Results The HGs were negatively correlated with the radiologic parameters with the highest correlation coefficient between HGs and skeletal age of hand and wrist. The negative correlation between HGs and the 2 clinical parameters was significant and could be enhanced by combining with the radiologic parameters. No proliferative chondrocyte zone of the apophysis was detected when patients were either over 16 years of skeletal age or Risser grade 5, as well as 2-year postmenarche or over 15 years of chronological age in patients with DSA stage III and Risser grade 4. Conclusion Radiologic skeletal age of the wrist and digits can provide important information for maturity assessment in girls with AIS. It can also enhance the sensitivity of clinical parameters in determining the remaining growth potential.

To ascertain the correlation between histological grades (HGs) of vertebral growth plates and Risser grades in idiopathic scoliosis (IS) patients; to identify whether digital skeletal age (DSA) is a reliable indicator for accurate evaluation of the spinal residual growth potential.Twenty eight Chinese female patients were available for this study. Superior and inferior growth plates were obtained at each level when anterior approach surgeries were performed. Histological examinations were conducted after the specimens were processed. The patients were evaluated by DSA stages in this study. Correlations between histological grades, menarchal status, and chronological age were analyzed.There was a negative correlation between the following: HGs and DSA stages in 28 cases (r = -0.541, P = 0.003), and HGs and menarchal status in patients in DSA stage III (r = -0.591, P = 0.006). Statistical significance of growth activity of growth plates was found between patients in DSA-stage II and those in DSA-stage III (P = 0.014).DSA may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronological ages.

To investigate the correlation between histological grade (HG) of vertebral growth plates and Risser grade in the female idiopathic scoliosis (IS) patients; and to identify whether Risser grading is a reliable indicator for accurate evaluation of the spinal residual growth potential.Thirty-nine samples of vertebral growth plates obtained during operation from 15 females IS patients, all female, aged 15.1 (12.4 - 18.0), underwent HE staining and light microscopy to determine the values of HG. Xray photography of pelvis was conducted before operation to identify the Risser sign. The correlation of Risser grade with pubertal status was analyzed.All the vertebral growth plates of the IS patients with the Risser grade of 0 showed growth activity. The vertebral growth plates showed HG II activity in 6 of the 16 IS patients with the Risser grade of 4. All the vertebral growth plates showed no growth activity in the 3 IS patients with the Risser grade of 5. There was a negative correlation between the HG and Risser grade in all 39 patients (r = -0.645, P =0.000). The HG of the patients with the Risser grade of 4 was negatively correlated with the menarchal status (time between menarche and operation) (r = -0.710, P = 0.002). The residual growth potential of spinal growth plates of the patients with the Risser grades of 2 - 5 was significantly lower than of the patients with the Risser grades of 0 - 1 (P = 0.020).Risser sign may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronological ages.

To evaluate the value of some parameters in predicting of growth peak height velocity (PHV) of the girls with adolescent idiopathic scoliosis (AIS) by histomorphological studying on iliac crest cartilage.Iliac crest cartilages were harvested during posterior surgery from girls with AIS. The samples were then paraffin embedded after stored in formalin solid over 24 hours, sectioned vertical to the calcification at the thickness of 5 microm, and stained with Hematoxylin and Eosin. The histological grading of the proliferating activity of it was observed under the microscope. Parameters included chronologic age, menarche status, wrist skeletal age, digital skeletal age, elbow epiphysis and Risser sign were recorded. The histological grading data were compared with these parameters in terms of their accuracy in the prediction of PHV of the scoliosis.The specimens of 53 AIS patients with an average age 14.0 years were stained successfully. The proliferating activity of the iliac crest cartilage decreased when the AIS girl was over 13.0 years of chronologic age, 14.0 years of wrist skeletal age, post menarche or Risser sign was no less than grade 3.All the parameters evaluated can be used to show the end of PHV. Three parameters, including 11 years old of chronologic age, 12 years of the wrist skeletal age, unfusion of the elbow epiphysis and the thelarche, can be used in predicting the beginning of PHV.

To analysis the potential effect of neurocentral cartilage (NCC) on the etiology of adolescent idiopathic scoliosis (AIS).Thirty patients with AIS (Group A) and 30 control subject with normal spine (Group B) were included in this study. The age is matched. Both groups were divided into two subgroups according to the age and each subgroup has 15 patients. The younger patients were put into subgroup A1, B1 and the older patients put into subgroup A2, B2. Computed tomography (CT) scanning was carried and the pedicle length, the angle composed by pedicle and vertebral midline (alpha) and the angle composed by NCC and vertebral midline (beta) at periapical vertebrae (T7-T10) were analyzed.The pedicle length showed no significant difference between group A and group B or between subgroup A1 and A2 or between B1 and B2. In each subgroup, no significant difference was found in alpha angle or beta angle between left side and right side (concave side and convex side).No significant pedicle growth has been found during pubertal both in AIS and normal patients. Few affect of neurocentral cartilage on the etiology of AIS has been found, which might because of low growth activity of NCC during puberty.

To investigate the association of vitamin D receptor (VDR) gene polymorphisms with abnormal growth pattern and low bone mass in adolescent idiopathic scoliosis (AIS) patients.Peripheral blood samples were obtained from 164 female patients with AIS, aged 14.4 +/- 2 (9 - 20), and 122 age-matched healthy girls. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect the VDR gene distributions.The frequency of Bb genotype was significantly higher in the AIS patients than in the controls (P0.01). The frequency of B alleles of the AIS patients was significantly higher than that of the controls (P0.01). In AIS patients, the expression rate of Aa genotype of the AIS patients with the body mass index (BMI)or = 18 kg/m(2) was significantly higher than those with the BMI18 kg/m(2) (P0.05), and the expression rate of Bb genotype of the AIS patients with the BMI18 kg/m(2) and arm span160 cm was significantly higher than that of the AIS patients with the BMIor = 18 kg/m(2) and arm spanor = 160 cm (P0.05).The BsmI site polymorphism of vitamin D receptor gene may be associated with abnormal growth pattern and low bone mass in girls with AIS.

Study Design. A prospective study. Objective. To ascertain the correlation between histologic grades (HGs) of vertebral growth plates and Risser grades as well as DSA stages in the Chinese female idiopathic scoliosis (IS) patients; to identify whether digital skeletal age (DSA) is a reliable indicator for accurate evaluation of the spinal residual growth potential. Summary of Background Data. DSA is considered one of the more important indicators for representing the peak height velocity (PHV) typically and predicting spinal growth potential. The correlation between HGs of growth plates and DSA stages in IS patients is unclear. Methods. Thirty-nine Chinese female patients were available for this study. Superior and inferior growth plates were obtained at each level when anterior approach surgeries were performed. Histologic examinations were conducted after the specimens were processed. Of these patients, 28 cases were evaluated by DSA stages in this study. Correlations between histologic grades, Risser grades, menarchal status, and chronologic age were analyzed in 39 patients. Correlations between histologic grades, DSA, menarchal status, and chronologic age were analyzed in 28 patients. Results. There was a negative correlation between the following: HGs and Risser grades in 39 patients (r = −0.645, P = 0.000–0.05), HGs and menarchal status in patients in Risser 4 (r = −0.710, P = 0.002–0.05), HGs and DSA stages in 28 cases (r = −0.541, P = 0.003–0.05), and HGs and menarchal status in patients in DSA Stage III (r = −0.591, P = 0.006–0.05). Statistical significance of growth activity of growth plates was found between patients in Risser Grades 0 to 1 and those in Risser Grades 2 to 5 (P = 0.020–0.05) and patients in DSA Stage II and those in DSA Stage III (P = 0.014–0.05). Conclusion. DSA may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronologic ages.

To investigate the correlation between the circulating leptin level and the anthropometric parameters and parameters related to pubertal growth, and to explore the role of leptin in the abnormal growth pattern in girls with adolescent idiopathic scoliosis (AIS).One hundred and twenty AIS girls selected randomly from the out-patient and in-patient departments, divided into 2 groups: Group A1 (n = 73, aged 10 - 13) and Group A2 (n = 47, aged 14 - 17), and 80 14 - 17 year-old healthy girl students receiving physical examination underwent measurement of body height and weight. Body mass index (BMI) was calculated. Peripheral fasting blood samples were collected to detect the level of leptin. The anthropometric data, pubertal status, and circulating leptin level were compared between the AIS girls and the controls. The relationships between leptin and age, menstrual status, body weight, height, BMI and Risser sign were analyzed in the AIS girls.Eighty-eight AIS girls (73%) and 14 healthy girls (18%) had a BMI score less than 18.0. The mean leptin level of Group A1 was 6.2 microg/L, significantly lower than of Group A2 (8.6 microg/L, P = 0.024). Compared with the healthy controls, the AIS girls had significantly greater corrected height (162.7 cm vs. 160.2 cm, P = 0.026), lower weight (44.3 kg vs. 53.6 kg, P = 0.01), lower BMI (17.5 kg/m(2) vs. 20.9 kg/m(2), P = 0.01), and lower circulating leptin (8.6 microg/L vs. 14.9 microg/L), even after the adjustment for age and menstrual status. An inverse correlation was observed between the leptin level and the age at menarche (AIS, r = -0.428, P0.001; controls, r = -0.280, P = 0.013). Whereas, positive correlations were found between leptin and age, menstrual status, body weight, height, BMI, and Risser sign (r = 0.234 - 0.506, P = 0.01 -0.001).AIS girls have markedly decreased circulating leptin level. Circulating leptin level is associated with body weight, BMI, and other growth parameters, suggesting that leptin may play an important role in the lower body mass in AIS girls.

Asymmetrical growth of the vertebrae has been implicated as one possible etiologic factor in the pathogenesis of adolescent idiopathic scoliosis. The longitudinal vertebral growth derives from the endochondral ossification of the vertebral growth plate. In the present study, the growth plates from the convex and concave side of the vertebrae were characterized by the method of histology and immunohistochemistry to evaluate the growth activity, cell proliferation, and apoptosis. Normal zoned architectures were observed in the convex side of the growth plate and disorganized architectures in the concave side. The histological grades were significantly different between the convex and the concave side of the growth plate in the apex vertebrae (P < 0.05). The histological difference was also found significant statistically between end vertebrae and apex vertebrae in the concave side of vertebral growth plates (P < 0.05). The proliferative potential indexes and apoptosis indexes of chondrocytes in the proliferative and hypertrophic zone in the convex side were significantly higher than that in the concave side in the apex vertebral growth plate (P < 0.05). There was a significant difference of the proliferative potential index (proliferating cell nuclear antigen, PCNA index) between convex side and concave side at the upper end vertebra (P < 0.05). The difference of the proliferative potential index and apoptosis index were found significant statistically in the concave side of the vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). The same result was also found for the apoptosis index (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labeling assay, TUNEL index) in the convex side of vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). Some correlation were found between radiographic measurements and proliferation and apoptosis indexes. The difference in histological grades and cellular activity between the convex and concave side indicated that the bilateral growth plate of the vertebrae in AIS patients have different growth kinetics which may affect the curve progression.