Lateral bone density variations in the scoliotic spine

Adam, Clayton J. and Askin, Geoffrey N. (2009) Lateral bone density variations in the scoliotic spine. Bone, 45 4: 799-807. doi:10.1016/j.bone.2009.06.023

Author Adam, Clayton J.
Askin, Geoffrey N.
Title Lateral bone density variations in the scoliotic spine
Journal name Bone   Check publisher's open access policy
ISSN 8756-3282
Publication date 2009-10-01
Sub-type Article (original research)
DOI 10.1016/j.bone.2009.06.023
Volume 45
Issue 4
Start page 799
End page 807
Total pages 9
Place of publication Philadelphia, United States
Publisher Elsevier
Language eng
Formatted abstract
Adolescent Idiopathic Scoliosis (AIS) is the most common deformity of the spine, affecting 2–4% of the population. Previous studies have shown that the vertebrae in scoliotic spines undergo abnormal shape changes, however there has been little exploration of how scoliosis affects bone density distribution within the vertebrae.

In this study, existing CT scans of 53 female idiopathic scoliosis patients with right-sided main thoracic curves were used to measure the lateral (right to left) bone density profile at mid-height through each vertebral body. Five key bone density profile measures were identified from each normalized bone density distribution, and multiple regression analysis was performed to explore the relationship between bone density distribution and patient demographics (age, height, weight, body mass index (BMI), skeletal maturity, time since Menarche, vertebral level, and scoliosis curve severity).

Results showed a marked convex/concave asymmetry in bone density for vertebral levels at or near the apex of the scoliotic curve. At the apical vertebra, mean bone density at the left side (concave) cortical shell was 23.5% higher than for the right (convex) cortical shell, and cancellous bone density along the central 60% of the lateral path from convex to concave increased by 13.8%. The centre of mass of the bone density profile at the thoracic curve apex was located 53.8% of the distance along the lateral path, indicating a shift of nearly 4% toward the concavity of the deformity. These lateral bone density gradients tapered off when moving away from the apical vertebra. Multi-linear regressions showed that the right cortical shell peak bone density is significantly correlated with skeletal maturity, with each Risser increment corresponding to an increase in mineral equivalent bone density of 4–5%. There were also statistically significant relationships between patient height, weight and BMI, and the gradient of cancellous bone density along the central 60% of the lateral path. Bone density gradient is positively correlated with weight, and negatively correlated with height and BMI, such that at the apical vertebra, a unit decrease in BMI corresponds to an almost 100% increase in bone density gradient.
Keyword Adolescent idiopathic scoliosis
Bone density distribution
Computed tomography
Spinal deformity
Thoracolumbar spine
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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