Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study
Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitu...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Brink, Rob C. [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2017 |
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| Schlagwörter: |
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| Anmerkung: |
© Scoliosis Research Society 2016 |
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| Übergeordnetes Werk: |
Enthalten in: Spine deformity - Amsterdam [u.a.] : Elsevier, 2013, 5(2017), 1 vom: Jan., Seite 37-45 |
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| Übergeordnetes Werk: |
volume:5 ; year:2017 ; number:1 ; month:01 ; pages:37-45 |
| Links: |
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| DOI / URN: |
10.1016/j.jspd.2016.08.006 |
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| Katalog-ID: |
SPR038870398 |
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| 245 | 1 | 0 | |a Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study |
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| 520 | |a Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. | ||
| 650 | 4 | |a Adolescent idiopathic scoliosis |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Transverse plane morphology |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Axial rotation |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Vertebral body asymmetry |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Pedicle asymmetry |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a CT scan |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Schlösser, Tom P. C. |4 aut | |
| 700 | 1 | |a Colo, Dino |4 aut | |
| 700 | 1 | |a Vincken, Koen L. |4 aut | |
| 700 | 1 | |a van Stralen, Marijn |4 aut | |
| 700 | 1 | |a Hui, Steve C. N. |4 aut | |
| 700 | 1 | |a Chu, Winnie C. W. |4 aut | |
| 700 | 1 | |a Cheng, Jack C. Y. |4 aut | |
| 700 | 1 | |a Castelein, René M. |4 aut | |
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10.1016/j.jspd.2016.08.006 doi (DE-627)SPR038870398 (SPR)j.jspd.2016.08.006-e DE-627 ger DE-627 rakwb eng Brink, Rob C. verfasserin aut Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2016 Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 Schlösser, Tom P. C. aut Colo, Dino aut Vincken, Koen L. aut van Stralen, Marijn aut Hui, Steve C. N. aut Chu, Winnie C. W. aut Cheng, Jack C. Y. aut Castelein, René M. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 5(2017), 1 vom: Jan., Seite 37-45 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:5 year:2017 number:1 month:01 pages:37-45 https://dx.doi.org/10.1016/j.jspd.2016.08.006 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 5 2017 1 01 37-45 |
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10.1016/j.jspd.2016.08.006 doi (DE-627)SPR038870398 (SPR)j.jspd.2016.08.006-e DE-627 ger DE-627 rakwb eng Brink, Rob C. verfasserin aut Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2016 Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 Schlösser, Tom P. C. aut Colo, Dino aut Vincken, Koen L. aut van Stralen, Marijn aut Hui, Steve C. N. aut Chu, Winnie C. W. aut Cheng, Jack C. Y. aut Castelein, René M. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 5(2017), 1 vom: Jan., Seite 37-45 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:5 year:2017 number:1 month:01 pages:37-45 https://dx.doi.org/10.1016/j.jspd.2016.08.006 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 5 2017 1 01 37-45 |
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10.1016/j.jspd.2016.08.006 doi (DE-627)SPR038870398 (SPR)j.jspd.2016.08.006-e DE-627 ger DE-627 rakwb eng Brink, Rob C. verfasserin aut Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2016 Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 Schlösser, Tom P. C. aut Colo, Dino aut Vincken, Koen L. aut van Stralen, Marijn aut Hui, Steve C. N. aut Chu, Winnie C. W. aut Cheng, Jack C. Y. aut Castelein, René M. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 5(2017), 1 vom: Jan., Seite 37-45 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:5 year:2017 number:1 month:01 pages:37-45 https://dx.doi.org/10.1016/j.jspd.2016.08.006 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 5 2017 1 01 37-45 |
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10.1016/j.jspd.2016.08.006 doi (DE-627)SPR038870398 (SPR)j.jspd.2016.08.006-e DE-627 ger DE-627 rakwb eng Brink, Rob C. verfasserin aut Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2016 Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 Schlösser, Tom P. C. aut Colo, Dino aut Vincken, Koen L. aut van Stralen, Marijn aut Hui, Steve C. N. aut Chu, Winnie C. W. aut Cheng, Jack C. Y. aut Castelein, René M. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 5(2017), 1 vom: Jan., Seite 37-45 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:5 year:2017 number:1 month:01 pages:37-45 https://dx.doi.org/10.1016/j.jspd.2016.08.006 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 5 2017 1 01 37-45 |
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10.1016/j.jspd.2016.08.006 doi (DE-627)SPR038870398 (SPR)j.jspd.2016.08.006-e DE-627 ger DE-627 rakwb eng Brink, Rob C. verfasserin aut Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Scoliosis Research Society 2016 Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 Schlösser, Tom P. C. aut Colo, Dino aut Vincken, Koen L. aut van Stralen, Marijn aut Hui, Steve C. N. aut Chu, Winnie C. W. aut Cheng, Jack C. Y. aut Castelein, René M. aut Enthalten in Spine deformity Amsterdam [u.a.] : Elsevier, 2013 5(2017), 1 vom: Jan., Seite 37-45 (DE-627)747142815 (DE-600)2717704-X 2212-1358 nnns volume:5 year:2017 number:1 month:01 pages:37-45 https://dx.doi.org/10.1016/j.jspd.2016.08.006 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_647 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2190 GBV_ILN_2336 AR 5 2017 1 01 37-45 |
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Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. 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Brink, Rob C. misc Adolescent idiopathic scoliosis misc Transverse plane morphology misc Axial rotation misc Vertebral body asymmetry misc Pedicle asymmetry misc CT scan Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study |
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Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study Adolescent idiopathic scoliosis (dpeaa)DE-He213 Transverse plane morphology (dpeaa)DE-He213 Axial rotation (dpeaa)DE-He213 Vertebral body asymmetry (dpeaa)DE-He213 Pedicle asymmetry (dpeaa)DE-He213 CT scan (dpeaa)DE-He213 |
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Brink, Rob C. Schlösser, Tom P. C. Colo, Dino Vincken, Koen L. van Stralen, Marijn Hui, Steve C. N. Chu, Winnie C. W. Cheng, Jack C. Y. Castelein, René M. |
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asymmetry of the vertebral body and pedicles in the true transverse plane in adolescent idiopathic scoliosis: a ct-based study |
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Asymmetry of the Vertebral Body and Pedicles in the True Transverse Plane in Adolescent Idiopathic Scoliosis: A CT-Based Study |
| abstract |
Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. © Scoliosis Research Society 2016 |
| abstractGer |
Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. © Scoliosis Research Society 2016 |
| abstract_unstemmed |
Study Design Cross-sectional. Objectives To quantify the asymmetry of the vertebral bodies and pedicles in the true transverse plane in adolescent idiopathic scoliosis (AIS) and to compare this with normal anatomy. Summary of background data There is an ongoing debate about the existence and magnitude of the vertebral body and pedicle asymmetry in AIS and whether this is an expression of a primary growth disturbance, or secondary to asymmetrical loading. Methods Vertebral body asymmetry, defined as left-right overlap of the vertebral endplates (ie, 100%: perfect symmetry, 0%: complete asymmetry) was evaluated in the true transverse plane on CT scans of 77 AIS patients and 32 non-scoliotic controls. Additionally, the pedicle width, length, and angle and the length of the ideal screw trajectory were calculated. Results Scoliotic vertebrae were on average more asymmetric than controls (thoracic: AIS 96.0% vs. controls 96.4%; p =.005, lumbar: 95.8% vs. 97.2%; p <.001) and more pronounced around the thoracic apex (95.8%) than at the end vertebrae (96.3%; p =.031). In the thoracic apex; the concave pedicle was thinner (4.5 vs. 5.4 mm; p <.001) and longer (20.9 vs. 17.9 mm; p <.001), the length of the ideal screw trajectory was longer (43.0 vs. 37.3 mm; p <.001), and the transverse pedicle angle was greater (12.3° vs. 5.7°; p <.001) than the convex one. The axial rotation showed no clear correlation with the asymmetry. Conclusions Even in non-scoliotic controls is a degree of vertebral body and pedicle asymmetry, but scoliotic vertebrae showed slightly more asymmetry, mostly around the thoracic apex. In contrast to the existing literature, there is no major asymmetry in the true transverse plane in AIS and no uniform relation between the axial rotation and vertebral asymmetry could be observed in these moderate to severe patients, suggesting that asymmetrical vertebral growth does not initiate rotation, but rather follows it as a secondary phenomenon. Level of Evidence Level 4. © Scoliosis Research Society 2016 |
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