Journal ArticleDOI
Morphological and functional electrophysiological evidence of relative spinal cord tethering in adolescent idiopathic scoliosis.
Winnie C.W. Chu,Gene Chi Wai Man,Wynnie W.M. Lam,Benson H. Y. Yeung,Wai-Wang Chau,Bobby K. W. Ng,Tsz Ping Lam,Kwong-Man Lee,Jack C. Y. Cheng +8 more
TLDR
This study suggests presence of tethering and increased tension along the longitudinal axis of spinal cord with associated morphologic changes of cross-sectional shape and relative position of the cord.Abstract:
STUDY DESIGN: Magnetic resonance (MR) imaging and multiplanar reconstruction was used to evaluate the morphology and relative position of the spinal cord in adolescent idiopathic scoliosis (AIS). OBJECTIVE: To determine the longitudinal and cross-sectional morphology of spinal cord in AIS subjects versus normal controls and their correlation with relative position of cerebellar tonsils and somatosensory cortical evoked potentials (SSEP). SUMMARY OF BACKGROUND DATA: Our previous studies revealed significantly reduced spinal cord to vertebral column length ratios in AIS patients with severe scoliotic curves suggesting the presence of disproportional growth between the neural and skeletal system. A possible neural origin of etiopathogenesis of AIS is suggested. METHODS: MR multiplanar reconstruction was performed in 97 adolescent girls (35 moderate, 26 severe AIS with right-sided thoracic/thoracolumbar curve, and 36 age-matched controls). Measurements of the ratio of anteroposterior (AP) and transverse (TS) diameter of the cord, the concave and convex lateral cord space (LCS) were obtained at the apical level in AIS subjects. Same parameters were obtained in normal controls at matched vertebral levels. Correlations were made with cord to vertebral column length ratio, cerebellar tonsil position and SSEP findings. RESULTS: AP/TS cord ratio and LCS ratio were increased in AIS subjects in the presence of reduced spinal cord to vertebral length ratio when compared with normal controls (P < 0.05). The above ratios were exaggerated in AIS subjects with abnormal SSEP findings. The AP/TS cord ratio and LCS ratio were negatively correlated with the cord to vertebral column length ratio (rho = -0.410 and -0.313, P < 0.01) and cerebellar tonsillar level (rho = -0.309 and -0.432, P < 0.01). CONCLUSION: Our study suggests presence of tethering and increased tension along the longitudinal axis of spinal cord with associated morphologic changes of cross-sectional shape and relative position of the cord.read more
Citations
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Journal ArticleDOI
Mathematical Theory Of Elasticity
TL;DR: Sokolnikoff's book as discussed by the authors differs greatly from Southwell, Timoshenko, and Love in spirit and content, and is symptomatic of the change in outlook of American mathematics over the past few decades.
Journal ArticleDOI
Adolescent idiopathic scoliosis.
Jack C. Y. Cheng,René M. Castelein,Winnie C.W. Chu,Aina J. Danielsson,Aina J. Danielsson,Matthew B. Dobbs,Theodoros B Grivas,Christina A. Gurnett,Keith D. K. Luk,Alain Moreau,Peter O. Newton,Peter O. Newton,Ian A. F. Stokes,Stuart L. Weinstein,R Geoffrey Burwell +14 more
TL;DR: Both the prevention of AIS and the treatment of its direct underlying cause are not possible, because the definite aetiology and aetiopathogenetic mechanisms that underlie AIS are still unclear.
Journal ArticleDOI
The pathogenesis of adolescent idiopathic scoliosis: review of the literature.
TL;DR: Although any or all of the mentioned factors may play a certain role in the initiation and progression of AIS at a certain stage, the presented material suggests that in the observed deformation, genetics, and the unique mechanics of the fully upright human spine play a decisive role.
Journal ArticleDOI
Top theories for the etiopathogenesis of adolescent idiopathic scoliosis.
Wei-jun Wang,Hiu Yan Yeung,Winne Chiu-Wing Chu,Nelson L.S. Tang,Kwong Man Lee,Yong Qiu,Richard Geoffrey Burwell,Jack C. Y. Cheng +7 more
TL;DR: An overview of the current main hypothetical “concepts” on the etiopathogenesis of AIS is provided to stimulate further innovative thoughts, research, and especially collaborative research in this area of great interest.
Journal ArticleDOI
Pathogenesis of adolescent idiopathic scoliosis in girls - a double neuro-osseous theory involving disharmony between two nervous systems, somatic and autonomic expressed in the spine and trunk: possible dependency on sympathetic nervous system and hormones with implications for medical therapy
R Geoffrey Burwell,R K Aujla,M.P. Grevitt,Peter Dangerfield,Alan Moulton,Tabitha Randell,Susan I. Anderson +6 more
TL;DR: A speculative pathogenetic theory is formulated that AIS in girls results from developmental disharmony expressed in spine and trunk between autonomic and somatic nervous systems, and implications are discussed for neuroendocrine dysfunctions, osteopontin, sympathoactivation, medical therapy, Rett and Prader-Willi syndromes, infantile idiopathic scoliosis, and human evolution.
References
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Journal ArticleDOI
Mathematical Theory Of Elasticity
TL;DR: Sokolnikoff's book as discussed by the authors differs greatly from Southwell, Timoshenko, and Love in spirit and content, and is symptomatic of the change in outlook of American mathematics over the past few decades.
Journal ArticleDOI
Position of cerebellar tonsils in the normal population and in patients with Chiari malformation: a quantitative approach with MR imaging.
TL;DR: Magnetic resonance imaging was used to define quantitatively the position of the cerebellar tonsils in the normal population and in patients with Chiari malformations, and extension of the tonsils below the foramen magnum is considered normal up to 3 mm, borderline between 3 and 5 mm, and clearly pathologic when it exceeds 5 mm.
Journal ArticleDOI
The variation of position of the conus medullaris in an adult population. A magnetic resonance imaging study.
TL;DR: The distribution of conus location in a large adult population was shown to range from the middle third of T12 to the upper third of L3, and no significant difference in conus position was seen between male and female patients or with increasing age.
Journal ArticleDOI
Relative anterior spinal overgrowth in adolescent idiopathic scoliosis: RESULTS OF DISPROPORTIONATE ENDOCHONDRAL-MEMBRANOUS BONE GROWTH
TL;DR: The text for this EFG was written by Professor Jack Cheng and his colleagues who used whole spine magnetic resonance imaging (MRI) to re-investigate the relative anterior spinal overgrowth of progressive AIS in a cross-sectional study and three new hypotheses are proposed to interpret their findings.
Journal ArticleDOI
Aetiology of idiopathic scoliosis: current concepts.
TL;DR: A neurodevelopmental concept is outlined for the aetiology of progressive AIS that involves lipid peroxidation and, if substantiated, has initial therapeutic potential by dietary anti-oxidants.