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Soh RCC, Chen BZ, Hartono S, Lee MS, Lee W, Lim SL, Gan J, Maréchal B, Chan LL, Lo YL. The hindbrain and cortico-reticular pathway in adolescent idiopathic scoliosis. Clin Radiol 2024; 79:e759-e766. [PMID: 38388254 DOI: 10.1016/j.crad.2024.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 02/24/2024]
Abstract
AIM To characterise the corticoreticular pathway (CRP) in a case-control cohort of adolescent idiopathic scoliosis (AIS) patients using high-resolution slice-accelerated readout-segmented echo-planar diffusion tensor imaging (DTI) to enhance the discrimination of small brainstem nuclei in comparison to automated whole-brain volumetry and tractography and their clinical correlates. MATERIALS AND METHODS Thirty-four participants (16 AIS patients, 18 healthy controls) underwent clinical and orthopaedic assessments and brain magnetic resonance imaging (MRI) on a 3 T MRI machine. Automated whole-brain volume-based morphometry, tract-based spatial statistics analysis, and manual CRP tractography by two independent raters were performed. Intra-rater and inter-rater agreement of DTI metrics from CRP tractography were assessed by intraclass correlation coefficient. Normalised structural brain volumes and DTI metrics were compared between groups using Student's t-tests. Linear correlation analysis between imaging parameters and clinical scores was also performed. RESULTS AIS patients demonstrated a significantly larger pons volume compared to controls (p=0.006). Significant inter-side CRP differences in mean (p=0.02) and axial diffusivity (p=0.01) were found in patients only. Asymmetry in CRP fractional anisotropy significantly correlated with the Cobb angle (p=0.03). CONCLUSION Relative pontine hypertrophy and asymmetry in CRP DTI metrics suggest central supranuclear inter-hemispheric imbalance in AIS, and support the role of the CRP in axial muscle tone. Longitudinal evaluation of CRP DTI metrics in the prediction of AIS progression may be clinically relevant.
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Affiliation(s)
- R C C Soh
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore
| | - B Z Chen
- Singapore General Hospital, Singapore
| | - S Hartono
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
| | - M S Lee
- Singapore General Hospital, Singapore
| | - W Lee
- Singapore General Hospital, Singapore
| | - S L Lim
- Singapore General Hospital, Singapore
| | - J Gan
- Siemens Healthineers, Singapore
| | - B Maréchal
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland; Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Signal Processing Laboratory (LTS 5), École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - L L Chan
- Singapore General Hospital, Singapore; Duke-NUS Medical School, Singapore.
| | - Y L Lo
- Duke-NUS Medical School, Singapore; National Neuroscience Institute, Singapore
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Guo Z, Li D, Zang X. Congenital hemivertebrae combined with situs inversus totalis: A rare case report. Medicine (Baltimore) 2024; 103:e37625. [PMID: 38552073 PMCID: PMC10977591 DOI: 10.1097/md.0000000000037625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 02/26/2024] [Indexed: 04/02/2024] Open
Abstract
RATIONALE Situs inversus totalis is a rare malposition of organs that typically involves lesions in the respiratory, circulatory, or urinary systems. Cases of congenital hemivertebrae combined with situs inversus totalis are extremely rare and have limited reports. PATIENT CONCERNS We report a 2.5 years old girl with 2 congenital hemipyramids and complete visceral inversion who ultimately underwent hemilaminectomy. DIAGNOSIS Congenital hemivertebrae combined with situs inversus totalis. INTERVENTION The patient underwent hemilaminectomy. OUTCOMES The spinal deformity was corrected. LESSONS For patient with spinal deformities combined with situs inversus totalis, surgery can be an effective treatment method. But we also need to be vigilant about the dysfunction of various systems.
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Affiliation(s)
- Zheng Guo
- Orthopedics Department of the Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Donglai Li
- Orthopedics Department of the Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Xuehui Zang
- Department of Orthopaedics, Qilu Hospital of Shandong University, Jinan, People’s Republic of China
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3
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Pizones J, Chang DG, Suk SI, Izquierdo E. Current biomechanical theories on the etiopathogenesis of idiopathic scoliosis. Spine Deform 2024; 12:247-255. [PMID: 37975988 DOI: 10.1007/s43390-023-00787-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE There is great controversy about the etiologic origin of adolescent idiopathic scoliosis. Multiple theories have been suggested, including metabolic aspects, endocrine dysfunction, neurological central abnormalities, genetic predisposition and epigenetic factors involved in the development of scoliosis. However, there has always been speculations based on human biomechanical behavior. METHODS In this article, we performed a literature review on the biomechanical traits of human posture, and the proposed theories that explain the special characteristics present in idiopathic scoliosis. RESULTS The current theory on the etiopathogeneis of AIS suggests that dorsally directed shear loads acting on a preexisting axial plane rotation, in a posteriorly inclined sagittal plane of a growing patient, together with disc maturation, collagen quality at this phase of development and immaturity of proprioception, is the perfect scenario to spark rotational instability and create the three-dimensional deformity that defines idiopathic scoliosis. CONCLUSION The unique spinal alignment of human bipedalism, gravity and muscle forces acting straight above the pelvis to preserve an upright balance, and the instability of the soft tissue in a period of growth development, is an appealing cocktail to try to explain the genesis of this condition in humans.
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Affiliation(s)
- Javier Pizones
- Department of Orthopedic Surgery, Spine Unit, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046, Madrid, Spain.
| | - Dong-Gune Chang
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul, 50834, Korea
| | - Se-Il Suk
- Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul, 50834, Korea
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Mirasari I, Biakto KT, Nong I, Singjie LC. Congenital scoliosis associated with total situs inversus: A rare case report. Int J Surg Case Rep 2023; 111:108843. [PMID: 37725857 PMCID: PMC10518668 DOI: 10.1016/j.ijscr.2023.108843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Situs inversus totalis is a rare congenital abnormality characterized by a mirror-image transposition of both the abdominal and the thoracic organs. Vertebral anomalies causing congenital scoliosis are classified on the basis of failures of formation, segmentation, or both. The hallmark of surgical treatment is early intervention before the development of large curvatures. The surgical treatment of a congenital deformity mandates the use of neurological monitoring to minimize the risk of perioperative neurological deficit. CASE PRESENTATION We present a 21-year-old patient who was admitted for her scoliosis deformity correction. Complaints of back pain when standing for a long time and carrying heavy loads for too long. Her systemic examination revealed the apex cardiac beat on the right side, liver dullness on the left side, and rib hump deformity. CLINICAL DISCUSSION Congenital scoliosis is the most frequent congenital deformity of the spine. Congenital curvatures are due to anomalous development of the vertebrae (failure of formation and/or segmentation). Congenital scoliosis is believed to be related to an insult to the fetus during spine embryological development and associated malformations. In our case, the X-ray showed that the cardiac apex, spleen, stomach, and aorta were present on the right side, and the larger liver lobe and inferior vena cava were noted on the left side. Thus, the image manifestations supported the diagnosis of situs inversus totalis. CONCLUSION Corrective surgery with osteotomy could be a safe and effective for the treatment of scoliosis associated with situs inversus totalis.
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Affiliation(s)
- Indah Mirasari
- Orthopedic and Traumatology Department, Hasanuddin University, Makassar 90245, Indonesia
| | - Karya Triko Biakto
- Orthopedic and Traumatology Department, Hasanuddin University, Makassar 90245, Indonesia
| | - Ira Nong
- Orthopedic and Traumatology Department, Hasanuddin University, Makassar 90245, Indonesia
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Xie H, Kang Y, Liu J, Huang M, Dai Z, Shi J, Wang S, Li L, Li Y, Zheng P, Sun Y, Han Q, Zhang J, Zhu Z, Xu L, Yelick PC, Cao M, Zhao C. Ependymal polarity defects coupled with disorganized ciliary beating drive abnormal cerebrospinal fluid flow and spine curvature in zebrafish. PLoS Biol 2023; 21:e3002008. [PMID: 36862758 PMCID: PMC10013924 DOI: 10.1371/journal.pbio.3002008] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 03/14/2023] [Accepted: 01/20/2023] [Indexed: 03/03/2023] Open
Abstract
Idiopathic scoliosis (IS) is the most common spinal deformity diagnosed in childhood or early adolescence, while the underlying pathogenesis of this serious condition remains largely unknown. Here, we report zebrafish ccdc57 mutants exhibiting scoliosis during late development, similar to that observed in human adolescent idiopathic scoliosis (AIS). Zebrafish ccdc57 mutants developed hydrocephalus due to cerebrospinal fluid (CSF) flow defects caused by uncoordinated cilia beating in ependymal cells. Mechanistically, Ccdc57 localizes to ciliary basal bodies and controls the planar polarity of ependymal cells through regulating the organization of microtubule networks and proper positioning of basal bodies. Interestingly, ependymal cell polarity defects were first observed in ccdc57 mutants at approximately 17 days postfertilization, the same time when scoliosis became apparent and prior to multiciliated ependymal cell maturation. We further showed that mutant spinal cord exhibited altered expression pattern of the Urotensin neuropeptides, in consistent with the curvature of the spine. Strikingly, human IS patients also displayed abnormal Urotensin signaling in paraspinal muscles. Altogether, our data suggest that ependymal polarity defects are one of the earliest sign of scoliosis in zebrafish and disclose the essential and conserved roles of Urotensin signaling during scoliosis progression.
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Affiliation(s)
- Haibo Xie
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China
- Affiliated Hospital of Guangdong Medical University & Key Laboratory of Zebrafish Model for Development and Disease of Guangdong Medical University, Zhanjiang, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Yunsi Kang
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Junjun Liu
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Min Huang
- Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Department of Pathophysiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhicheng Dai
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing China
| | - Jiale Shi
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Shuo Wang
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Lanqin Li
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Yuan Li
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Pengfei Zheng
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Yi Sun
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Qize Han
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
| | - Jingjing Zhang
- Affiliated Hospital of Guangdong Medical University & Key Laboratory of Zebrafish Model for Development and Disease of Guangdong Medical University, Zhanjiang, China
- The Marine Biomedical Research Institute of Guangdong Zhanjiang, Zhanjiang, China
| | - Zezhang Zhu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing China
| | - Leilei Xu
- Division of Spine Surgery, Department of Orthopedic Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing China
| | - Pamela C. Yelick
- Department of Orthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Muqing Cao
- Key Laboratory of Cell Differentiation and Apoptosis of Chinese Ministry of Education, Department of Pathophysiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chengtian Zhao
- Institute of Evolution & Marine Biodiversity, Ocean University of China, Qingdao, China
- Laboratory for Marine Biology and Biotechnology, Qingdao National Laboratory for Marine Science and Technology, Qingdao, China
- Fang Zongxi Center, Key Laboratory of Marine Genetics and Breeding, College of Marine Life Sciences, Ocean University of China, Qingdao, China
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Meyer-Miner A, Van Gennip JL, Henke K, Harris MP, Ciruna B. using a new katnb1 scoliosis model. iScience 2022; 25:105028. [PMID: 36105588 PMCID: PMC9464966 DOI: 10.1016/j.isci.2022.105028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/15/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Anne Meyer-Miner
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Molecular Genetics, The University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jenica L.M. Van Gennip
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Molecular Genetics, The University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Katrin Henke
- Department of Orthopedic Research, Boston Children’s Hospital, Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
- Department of Orthopaedics and Department of Human Genetics, Emory University, Atlanta, GA 30322, USA
| | - Matthew P. Harris
- Department of Orthopedic Research, Boston Children’s Hospital, Department of Genetics, Harvard Medical School, Boston, MA 02115, USA
| | - Brian Ciruna
- Program in Developmental & Stem Cell Biology, The Hospital for Sick Children, 686 Bay Street, Toronto, ON M5G 0A4, Canada
- Department of Molecular Genetics, The University of Toronto, Toronto, ON M5S 1A8, Canada
- Corresponding author
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7
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Guo T, Lu C, Yang D, Lei C, Liu Y, Xu Y, Yang B, Wang R, Luo H. Case Report: DNAAF4 Variants Cause Primary Ciliary Dyskinesia and Infertility in Two Han Chinese Families. Front Genet 2022; 13:934920. [PMID: 35903363 PMCID: PMC9315306 DOI: 10.3389/fgene.2022.934920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Primary ciliary dyskinesia (PCD) is a rare genetic disorder, predominantly autosomal recessive. The dynein axonemal assembly factor 4 (DNAAF4) is mainly involved in the preassembly of multisubunit dynein protein, which is fundamental to the proper functioning of cilia and flagella. There are few reports of PCD-related pathogenic variants of DNAAF4, and almost no DNAAF4-related articles focused on sperm phenotype. Moreover, the association between DNAAF4 and scoliosis has never been reported, to the best of our knowledge.Materials and Methods: We recruited two patients with a clinical diagnosis of PCD. One came from a consanguineous and another from a non-consanguineous family. Clinical data, laboratory test results, and imaging data were analyzed. Through whole exome sequencing, immunofluorescence, electron microscopy, high-speed video microscopy analysis, and hematoxylin–eosin (HE) staining, we identified the disease-associated variants and validated the pathogenicity.Results: Proband 1 (P1, F1: II-1), a 19-year-old man, comes from a non-consanguineous family-I, and proband 2 (P2, F2: II-1), a 37-year-old woman, comes from a consanguineous family-II. Both had sinusitis, bronchiectasis, situs inversus, and scoliosis. P1 also had asthenoteratozoospermia, and P2 had an immature uterus. Two homozygous pathogenic variants in DNAAF4 (NM_130810.4), c.988C > T, p.(Arg330Trp), and DNAAF4 (NM_130810.4), c.733 C > T, p.(Arg245*), were identified through whole exome sequencing. High-speed microscopy analysis showed that most of the cilia were static in P1, with complete static of the respiratory cilia in P2. Immunofluorescence showed that the outer dynein arms (ODA) and inner dynein arms (IDA) were absent in the respiratory cilia of both probands, as well as in the sperm flagellum of P1. Transmission electron microscopy revealed the absence of ODA and IDA of respiratory cilia of P2, and HE staining showed irregular, short, absent, coiled, and bent flagella.Conclusion: Our study identified a novel variant c.733C > T, which expanded the spectrum of DNAAF4 variants. Furthermore, we linked DNAAF4 to asthenoteratozoospermia and likely scoliosis in patients with PCD. This study will contribute to a better understanding of PCD.
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Affiliation(s)
- Ting Guo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Chenyang Lu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Danhui Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Cheng Lei
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Ying Liu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Yingjie Xu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Binyi Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
| | - Rongchun Wang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
- *Correspondence: Hong Luo, ; Rongchun Wang,
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- Research Unit of Respiratory Disease, Central South University, Changsha, China
- Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, China
- *Correspondence: Hong Luo, ; Rongchun Wang,
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8
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Role of Primary Cilia in Skeletal Disorders. Stem Cells Int 2022; 2022:6063423. [PMID: 35761830 PMCID: PMC9233574 DOI: 10.1155/2022/6063423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/23/2022] [Accepted: 06/03/2022] [Indexed: 11/26/2022] Open
Abstract
Primary cilia are highly conserved microtubule-based organelles that project from the cell surface into the extracellular environment and play important roles in mechanosensation, mechanotransduction, polarity maintenance, and cell behaviors during organ development and pathological changes. Intraflagellar transport (IFT) proteins are essential for cilium formation and function. The skeletal system consists of bones and connective tissue, including cartilage, tendons, and ligaments, providing support, stability, and movement to the body. Great progress has been achieved in primary cilia and skeletal disorders in recent decades. Increasing evidence suggests that cells with cilium defects in the skeletal system can cause numerous human diseases. Moreover, specific deletion of ciliary proteins in skeletal tissues with different Cre mice resulted in diverse malformations, suggesting that primary cilia are involved in the development of skeletal diseases. In addition, the intact of primary cilium is essential to osteogenic/chondrogenic induction of mesenchymal stem cells, regarded as a promising target for clinical intervention for skeletal disorders. In this review, we summarized the role of primary cilia and ciliary proteins in the pathogenesis of skeletal diseases, including osteoporosis, bone/cartilage tumor, osteoarthritis, intervertebral disc degeneration, spine scoliosis, and other cilium-related skeletal diseases, and highlighted their promising treatment methods, including using mesenchymal stem cells. Our review tries to present evidence for primary cilium as a promising target for clinical intervention for skeletal diseases.
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9
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Wang Y, Troutwine BR, Zhang H, Gray RS. The axonemal dynein heavy chain 10 gene is essential for monocilia motility and spine alignment in zebrafish. Dev Biol 2022; 482:82-90. [PMID: 34915022 PMCID: PMC8792996 DOI: 10.1016/j.ydbio.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
Adolescent idiopathic scoliosis (AIS) is a common pediatric musculoskeletal disorder worldwide, characterized by atypical spine curvatures in otherwise healthy children. Human genetic studies have identified candidate genes associated with AIS, however, only a few of these have been shown to recapitulate adult-viable scoliosis in animal models. Using an F0 CRISPR screening approach in zebrafish, we demonstrate that disruption of the dynein axonemal heavy chain 10 (dnah10) gene results in recessive adult-viable scoliosis in zebrafish. Using a stably segregating dnah10 mutant zebrafish, we showed that the ependymal monocilia lining the hindbrain and spinal canal displayed reduced beat frequency, which was correlated with the disassembly of the Reissner fiber and the onset of body curvatures. Taken together, these results suggest that monocilia function in larval zebrafish contributes to the polymerization of the Reissner fiber and straightening of the body axis.
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Affiliation(s)
- Yunjia Wang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China; Department of Nutritional Sciences, 200 W 24th Street, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Benjamin R Troutwine
- Department of Nutritional Sciences, 200 W 24th Street, The University of Texas at Austin, Austin, TX, 78712, USA
| | - Hongqi Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China.
| | - Ryan S Gray
- Department of Nutritional Sciences, 200 W 24th Street, The University of Texas at Austin, Austin, TX, 78712, USA.
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10
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Liu Z, Hai Y, Li Z, Wu L. Zebrafish and idiopathic scoliosis: the 'unknown knowns'. Trends Genet 2022; 38:524-528. [PMID: 35115176 DOI: 10.1016/j.tig.2022.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/17/2021] [Accepted: 01/04/2022] [Indexed: 11/19/2022]
Abstract
The etiology and heterogeneity of idiopathic scoliosis (IS) are poorly understood. Studies using scoliotic zebrafish models have indicated a potential link between ciliary defects and scoliosis. They may further explain the onset of IS partially. However, it is necessary to further interpret the link between this progress and clinical medicine.
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Affiliation(s)
- Ziyang Liu
- Department of Orthopedics, Capital Medical University, Beijing, China; Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Yong Hai
- Department of Orthopedics, Capital Medical University, Beijing, China; Department of Orthopedic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - Zhuoran Li
- Department of Neurology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lingyun Wu
- Karolinska Institutet, Stockholm, Sweden
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11
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Muñoz-Montecinos C, Romero A, Sepúlveda V, Vira MÁ, Fehrmann-Cartes K, Marcellini S, Aguilera F, Caprile T, Fuentes R. Turning the Curve Into Straight: Phenogenetics of the Spine Morphology and Coordinate Maintenance in the Zebrafish. Front Cell Dev Biol 2022; 9:801652. [PMID: 35155449 PMCID: PMC8826430 DOI: 10.3389/fcell.2021.801652] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022] Open
Abstract
The vertebral column, or spine, provides mechanical support and determines body axis posture and motion. The most common malformation altering spine morphology and function is adolescent idiopathic scoliosis (AIS), a three-dimensional spinal deformity that affects approximately 4% of the population worldwide. Due to AIS genetic heterogenicity and the lack of suitable animal models for its study, the etiology of this condition remains unclear, thus limiting treatment options. We here review current advances in zebrafish phenogenetics concerning AIS-like models and highlight the recently discovered biological processes leading to spine malformations. First, we focus on gene functions and phenotypes controlling critical aspects of postembryonic aspects that prime in spine architecture development and straightening. Second, we summarize how primary cilia assembly and biomechanical stimulus transduction, cerebrospinal fluid components and flow driven by motile cilia have been implicated in the pathogenesis of AIS-like phenotypes. Third, we highlight the inflammatory responses associated with scoliosis. We finally discuss recent innovations and methodologies for morphometrically characterize and analyze the zebrafish spine. Ongoing phenotyping projects are expected to identify novel and unprecedented postembryonic gene functions controlling spine morphology and mutant models of AIS. Importantly, imaging and gene editing technologies are allowing deep phenotyping studies in the zebrafish, opening new experimental paradigms in the morphometric and three-dimensional assessment of spinal malformations. In the future, fully elucidating the phenogenetic underpinnings of AIS etiology in zebrafish and humans will undoubtedly lead to innovative pharmacological treatments against spinal deformities.
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Affiliation(s)
- Carlos Muñoz-Montecinos
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Adrián Romero
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Vania Sepúlveda
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - María Ángela Vira
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Karen Fehrmann-Cartes
- Núcleo de Investigaciones Aplicadas en Ciencias Veterinarias y Agronómicas, Universidad de las Américas, Concepción, Chile
| | - Sylvain Marcellini
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Felipe Aguilera
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Departamento de Bioquímica y Biología Molecular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Teresa Caprile
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
| | - Ricardo Fuentes
- Departamento de Biología Celular, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
- Grupo de Procesos en Biología del Desarrollo (GDeP), Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción, Chile
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12
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Lu C, Yang D, Lei C, Wang R, Guo T, Luo H. Identification of Two Novel DNAAF2 Variants in Two Consanguineous Families with Primary Ciliary Dyskinesia. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2021; 14:1415-1423. [PMID: 34785929 PMCID: PMC8591118 DOI: 10.2147/pgpm.s338981] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 10/26/2021] [Indexed: 01/16/2023]
Abstract
Background Dynein axonemal assembly factor 2 (DNAAF2) is involved in the early preassembly of dynein in the cytoplasm, which is essential for motile cilia function. Primary ciliary dyskinesia (PCD) associated with DNAAF2 variants has rarely been reported in females with infertility. Moreover, there is no report linking DNAAF2 to scoliosis in human. Materials and Methods We recruited patients from two consanguineous families with a clinical diagnosis of PCD and collected their clinical history, laboratory tests, and radiographic data. Sequencing and bioinformatics analysis were then performed. Immunofluorescence and high-speed microscope analysis were used to support the pathogenicity of the variant. Results Proband 1, a 26-year-old female from family I, exhibited scoliosis, bronchiectasis, sinusitis, situs inversus, and infertility. We found a novel homozygous missense variant in DNAAF2, c.491T>C, p.(Leu164Pro) in this patient. Subsequent immunofluorescence indicated the absence of outer dynein arm and inner dynein arm of cilia, and high-speed microscopy analysis showed that the most of the cilia are static, which support the pathogenicity of this variant. Proband 2, a 53-year-old female, presented with bronchiectasis, sinusitis, and infertility. In this patient, a new homozygous frameshift variant DNAAF2, c.822del, p.(Ala275Profs*10) was identified. The disease-causing variants mentioned above are not included in the current authorized genetic databases. Conclusion Our findings expand the spectrum of DNAAF2 variants and link DNAAF2 to female infertility and likely scoliosis in patients with PCD.
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Affiliation(s)
- Chenyang Lu
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
| | - Danhui Yang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
| | - Cheng Lei
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
| | - Rongchun Wang
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
| | - Ting Guo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
| | - Hong Luo
- Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.,Research Unit of Respiratory Disease, Central South University, Changsha, People's Republic of China.,Hunan Diagnosis and Treatment Center of Respiratory Disease, Changsha, People's Republic of China
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13
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Lv X, Xu J, Jiang J, Wu P, Tan R, Wang B. Genetic animal models of scoliosis: A systematical review. Bone 2021; 152:116075. [PMID: 34174503 DOI: 10.1016/j.bone.2021.116075] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 02/07/2023]
Abstract
Scoliosis is a complex disease with undetermined pathogenesis and has a strong relationship with genetics. Models of scoliosis in animals have been established for better comprehending its pathogenesis and treatment. In this review, we searched all the genetic animal models with body curvature in databases, and reviewed the related genes and scoliosis types. Meanwhile, we also summarized the pathogenesis of scoliosis reported so far. Summarizing the positive phenotypic animal models contributes to a better understanding on the pathogenesis of scoliosis and facilitates the selection of experimental models when a possible pathogenic factor is concerned.
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Affiliation(s)
- Xin Lv
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Jinghong Xu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Jiajiong Jiang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Pengfei Wu
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Renchun Tan
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Bing Wang
- Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China.
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14
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Li Q, Zeng F, Chen T, Pu C, Liang Y, Zheng C. Anesthetic Management of Patients After Scoliosis Surgery: A Single-Center Retrospective Study. Orthop Surg 2020; 12:1753-1759. [PMID: 33043614 PMCID: PMC7767771 DOI: 10.1111/os.12798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 08/04/2020] [Accepted: 08/04/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the effect of anesthetic management on scoliosis surgery and review the incidence rate of perioperative adverse events. METHODS This was a retrospective study and approved by the ethics committee. Patients who underwent scoliosis surgery from April 2011 to March 2018 in the Third Hospital of ChengDu were enrolled in this study. Characteristics of patients were obtained from the hospital's electronic records. The following information on patients was collected: preoperative assessment details, premedication, type of anesthesia and operation, the main postoperative outcome, and complications. Data were presented as the mean ± standard deviations (SD) for normally distributed continuous variables and numbers for categorical variables. Statistical analyses were performed using SPSS version 22.0. RESULTS In total, 513 patients were enrolled in the present study. The main preoperative complication was cardiopulmonary dysfunction (386 cases, 75.24%). Anesthesia induction was performed with conscious tracheal intubation after oral surface anesthesia. In total, the common postoperative complications involved anesthesia (24 cases, 4.68%), surgery (23 cases, 4.48%), the respiratory system (138 cases, 26.90%), and the gastrointestinal tract (nine cases, 1.75%). The majority of postoperative complications were postoperative hypoxemia and hypercapnia, caused by poor cardiopulmonary function. Rare and serious complications still occurred. Three patients died in hospital. CONCLUSION Our study demonstrated a high incidence of complications in scoliosis surgery, especially postoperative complications. Extreme postoperative vigilance is required and high-level monitoring of conditions is highly recommended.
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Affiliation(s)
- Qiang Li
- Department of Anesthesiology, The Third People's Hospital of ChengduSouthwest Jiao Tong UniversityChengduChina
| | - Fei Zeng
- Center of Cardiac Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's HospitalChengduChina
| | - Tao Chen
- Department of Anesthesiology, The Third People's Hospital of ChengduSouthwest Jiao Tong UniversityChengduChina
| | - Chun Pu
- Department of Anesthesiology, The Third People's Hospital of ChengduSouthwest Jiao Tong UniversityChengduChina
| | - Yi‐jian Liang
- Department of Orthopaedics, The Third People's Hospital of ChengduSouthwest Jiao Tong UniversityChengduChina
| | - Chuan‐dong Zheng
- Department of Anesthesiology, The Third People's Hospital of ChengduSouthwest Jiao Tong UniversityChengduChina
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15
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Castelein RM, Pasha S, Cheng JC, Dubousset J. Idiopathic Scoliosis as a Rotatory Decompensation of the Spine. J Bone Miner Res 2020; 35:1850-1857. [PMID: 32697856 DOI: 10.1002/jbmr.4137] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 07/14/2020] [Accepted: 07/19/2020] [Indexed: 11/11/2022]
Abstract
Many years of dedicated research into the etiology of idiopathic scoliosis have not led to one unified theory. We propose that scoliosis is a mechanical, rotatory decompensation of the human spine that starts in the transverse, or horizontal, plane. The human spine is prone to this type of decompensation because of its unique and individually different, fully upright sagittal shape with some preexistent transverse plane rotation. Spinal stability depends on the integrity of a delicate system of stabilizers, in which intervertebral disc stiffness is crucial. There are two phases in life when important changes occur in the precarious balance between spinal loading and the disc's stabilizing properties: (i) during puberty, when loads and moment arms increase rapidly, while the disc's "anchor," the ring apophysis, matures from purely cartilaginous to mineralized to ultimately fused to the vertebral body, and (ii) in older age, when the torsional stiffness of the spinal segments decreases, due to disc degeneration and subsequent laxity of the fibers of the annulus fibrosus. During these crucial periods, transverse plane vertebral rotation can increase during a relatively brief window in time, either as adolescent idiopathic or degenerative de novo scoliosis. Much more is known of the biomechanical changes that occur during disc aging and degeneration than of the changing properties of the disc during maturation. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- René M Castelein
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Saba Pasha
- Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jack Cy Cheng
- Department of Orthopaedics and Traumatology, S. H. Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong.,Joint Scoliosis Research Center of The Chinese University of Hong Kong-Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong
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16
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Homans JF, de Reuver S, Heung T, Silversides CK, Oechslin EN, Houben ML, McDonald-McGinn DM, Kruyt MC, Castelein RM, Bassett AS. The role of 22q11.2 deletion syndrome in the relationship between congenital heart disease and scoliosis. Spine J 2020; 20:956-963. [PMID: 31958577 PMCID: PMC7246162 DOI: 10.1016/j.spinee.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT For over four decades, clinicians and researchers have suggested a relationship between congenital heart disease (CHD) and scoliosis, attributed to either the disease itself or to the long-term effects of cardiac surgery on the immature thoracic cage. However, no study has yet accounted for 22q11.2 deletion syndrome (22q11.2DS), the second most common cause of CHD after Down syndrome. 22q11.2DS has a scoliosis risk of 50%, but within 22q11.2DS a previous report found no significant association between scoliosis and CHD. We, therefore, hypothesized that scoliosis within a CHD cohort would be related to an underlying 22q11.2 deletion. PURPOSE To determine the prevalence of scoliosis in CHD patients with and without 22q11.2DS. STUDY DESIGN/SETTING Cross-sectional. PATIENT SAMPLE A well-characterized existing database of 315 adults with CHD (primarily tetralogy of Fallot), with (n=86) and without (n=229) 22q11.2DS, matched by sex and CHD severity, and excluding other known syndromic diagnoses. We compared the scoliosis prevalence of patients with 22q11.2DS and CHD patients to the prevalence of scoliosis in a cohort of adults with 22q11.2DS without CHD based on medical records. OUTCOME MEASURES Presence of scoliosis (Cobb angle ≥10°). METHODS We systematically determined the presence of scoliosis in all included patients using chest radiographs, blind to genetic diagnosis. Besides 22q11.2DS, we analyzed other suspected risk factors for scoliosis using a regression model: thoracotomy before the age of 12 years, severe CHD type and sex. RESULTS The prevalence of scoliosis in adults with CHD and 22q11.2DS (n=46, 53.5%) was significantly greater than in those without 22q11.2DS (n=18, 7.9%, p<.0001). The presence of a 22q11.2 deletion (odds ratio [OR] 25.4, 95% confidence interval [95% CI] 11.2-57.4, p<.0001), a history of thoracotomy before the age of 12 years (OR 3.5, 95% CI 1.6-8.1, p=.0027) and most complex CHD class (OR 2.3, 95% CI 1.1-4.7, p=.0196), but not sex, were significant independent predictors of scoliosis. In the 22q11.2DS group, a right-sided aortic arch was associated with a left thoracic scoliotic curve (p=.036). CONCLUSIONS The prevalence of scoliosis in those with CHD but without a 22q11.2 deletion approximates that of the general population. However, in the CHD population with a 22q11.2 deletion, the prevalence of scoliosis approximates that of others with 22q11.2DS. The pediatric surgical approach and severity of CHD were weaker independent contributors as compared to the 22q11.2 deletion. The results support the importance of a genetic diagnosis of 22q11.2DS to the risk of developing scoliosis in individuals with CHD. The 22q11.2 deletion may represent a common etiopathogenetic pathway for both CHD and scoliosis, possibly involving early laterality mechanisms.
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Affiliation(s)
- Jelle F Homans
- Department of Orthopedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 Utrecht, the Netherlands
| | - Steven de Reuver
- Department of Orthopedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 Utrecht, the Netherlands
| | - Tracy Heung
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada M5G 2N2; The Dalglish Family 22q Clinic for Adults, University Health Network, 200 Elizabeth St, Toronto, ON, Canada
| | - Candice K Silversides
- The Dalglish Family 22q Clinic for Adults, University Health Network, 200 Elizabeth St, Toronto, ON, Canada; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, 585 University Ave, Toronto, ON, Canada M5G 2N2; Division of Cardiology, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Erwin N Oechslin
- The Dalglish Family 22q Clinic for Adults, University Health Network, 200 Elizabeth St, Toronto, ON, Canada; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, 585 University Ave, Toronto, ON, Canada M5G 2N2; Division of Cardiology, Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Michiel L Houben
- Department of Pediatrics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Donna M McDonald-McGinn
- Division of Human Genetics, 22q and You Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Moyo C Kruyt
- Department of Orthopedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 Utrecht, the Netherlands
| | - René M Castelein
- Department of Orthopedic Surgery, University Medical Center Utrecht, P.O. Box 85500, 3508 Utrecht, the Netherlands
| | - Anne S Bassett
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada M5G 2N2; The Dalglish Family 22q Clinic for Adults, University Health Network, 200 Elizabeth St, Toronto, ON, Canada; Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, 585 University Ave, Toronto, ON, Canada M5G 2N2; Division of Cardiology, Department of Medicine, University Health Network, Toronto, ON, Canada; Toronto General Research Institute and Campbell Family Mental Health Research Institute, Toronto, ON, Canada.
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17
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Abstract
STUDY DESIGN Retrospective cohort study, Level of Evidence III. OBJECTIVE To determine the relationship between internal organ orientation and adolescent idiopathic scoliosis (AIS) convexity directionality. SUMMARY OF BACKGROUND DATA AIS affects 2% to 3% of the general population and demonstrations 80% to 99% right thoracic curve convexity. The mechanism of AIS as well as explanation for right-sided predominance is largely unknown. METHODS A retrospective chart review of all patients with dextrocardia from 2008 to 2018 was performed at a single institution. Upright chest x-rays and scoliosis x-rays were evaluated for scoliosis by measurement of Cobb angle. Chart review was performed to extract age, advanced imaging results, and surgical intervention. RESULTS Of 110 patients identified with dextrocardia, 19 patients exhibited radiographic features consistent with AIS (Cobb angle >10°). Fifteen (79%) of these patients demonstrated left-sided thoracic curvature. Six patients showed isolated dextrocardia with normal abdominal organ orientation; five patients (83%) showed left-sided thoracic curvature. There was not a statistical difference with regards to sex or curve severity. Magnetic resonance imaging (MRI) was performed on five patients with left-sided curvature without evidence of intra-spinal pathology. CONCLUSION Dextrocardia shows increased incidence of AIS in both male and female patients. Left-sided thoracic curvature in cases with concurrent dextrocardia may not be associated with intra-spinal pathology as seen in the general population. These data suggest that thoracic organ orientation affects AIS convexity directionality. LEVEL OF EVIDENCE 3.
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18
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The Changing Position of the Center of Mass of the Thorax During Growth in Relation to Pre-existent Vertebral Rotation. Spine (Phila Pa 1976) 2019; 44:679-684. [PMID: 30395092 DOI: 10.1097/brs.0000000000002927] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE The aim of this study was to analyze the thoracic center of mass (COM) position of children at different ages and evaluate its relation with the previously reported pre-existent rotational pattern of the normal spine. SUMMARY OF BACKGROUND DATA The normal, nonscoliotic thoracic spine is known to have a rotational pattern that changes direction during growth, a transition from left-sided toward right-sided rotation with increasing age. This matches the changing curve convexity seen when idiopathic scoliosis develops at different ages. Furthermore, the direction of pre-existent rotation was shown to be related to organ orientation; in situs inversus the rotation is opposite to situs solitus. METHODS Computed tomography (CT) scans of the thorax of infantile (0-4 years, n = 40), juvenile (4-10 years, n = 53), and adolescent (10-18 years, n = 62) children without spinal pathology were included from an existing database. The location of the COM inside the thorax was calculated based on Hounsfield-units, representing tissue mass. The COM offset was defined as the shortest distance to the midsagittal plane. RESULTS At the infantile age, the COM was 2.5 ± 2.1 mm on the right side, at juvenile age not significantly deviated, and at adolescent age 3.1 ± 2.3 mm on the left side of the midsagittal plane. The mean COM offset correlated linearly with age (r = 0.77, P < 0.001). CONCLUSION The COM shifts from slightly on the right side of the thorax at the infantile age, to neutral at juvenile age, to the left at adolescent age. This corresponds to the earlier demonstrated change in direction of pre-existent rotation in the normal spine with age, as well as with the well-known changing direction, from left to right, of thoracic curve convexity in scoliosis at different ages. LEVEL OF EVIDENCE N/ A.
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Sarwark JF, Castelein RM, Maqsood A, Aubin CE. The Biomechanics of Induction in Adolescent Idiopathic Scoliosis: Theoretical Factors. J Bone Joint Surg Am 2019; 101:e22. [PMID: 30893239 DOI: 10.2106/jbjs.18.00846] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- John F Sarwark
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | | | - Ayesha Maqsood
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
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Chan ED, Wooten WI, Hsieh EW, Johnston KL, Shaffer M, Sandhaus RA, van de Veerdonk F. Diagnostic evaluation of bronchiectasis. RESPIRATORY MEDICINE: X 2019. [DOI: 10.1016/j.yrmex.2019.100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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21
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Contarini M, Shoemark A, Rademacher J, Finch S, Gramegna A, Gaffuri M, Roncoroni L, Seia M, Ringshausen FC, Welte T, Blasi F, Aliberti S, Chalmers JD. Why, when and how to investigate primary ciliary dyskinesia in adult patients with bronchiectasis. Multidiscip Respir Med 2018; 13:26. [PMID: 30151188 PMCID: PMC6101078 DOI: 10.1186/s40248-018-0143-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Bronchiectasis represents the final pathway of several infectious, genetic, immunologic or allergic disorders. Accurate and prompt identification of the underlying cause is a key recommendation of several international guidelines, in order to tailor treatment appropriately. Primary ciliary dyskinesia (PCD) is a genetic cause of bronchiectasis in which failure of motile cilia leads to poor mucociliary clearance. Due to poor ciliary function in other organs, individuals can suffer from chronic rhinosinusitis, otitis media and infertility. This paper explores the current literature describing why, when and how to investigate PCD in adult patients with bronchiectasis. We describe the main PCD diagnostic tests and compare the two international PCD diagnostic guidelines. The expensive multi-test diagnostic approach requiring a high level of expertise and specialist equipment, make the multifaceted PCD diagnostic pathway complex. Therefore, the risk of late or missed diagnosis is high and has clinical and research implications. Defining the number of patients with bronchiectasis due to PCD is complex. To date, few studies outlining the aetiology of adult patients with bronchiectasis conduct screening tests for PCD, but they do differ in their diagnostic approach. Comparison of these studies reveals an estimated PCD prevalence of 1-13% in adults with bronchiectasis and describe patients as younger than their counterparts with moderate impairment of lung function and higher rates of chronic infection with Pseudomonas aeruginosa. Diagnosing PCD has clinical, socioeconomic and psychological implications, which affect patients' life, including the possibility to have a specific and multidisciplinary team approach in a PCD referral centre, as well as a genetic and fertility counselling and special legal aspects in some countries. To date no specific treatments for PCD have been approved, standardized diagnostic protocols for PCD and recent diagnostic guidelines will be helpful to accurately define a population on which planning RCT studies to evaluate efficacy, safety and accuracy of PCD specific treatments.
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Affiliation(s)
- Martina Contarini
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Amelia Shoemark
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Jessica Rademacher
- Department of Respiratory Medicine, Hannover Medical School and German Center for Lung Research (DZL), Hannover, Germany
| | - Simon Finch
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
| | - Andrea Gramegna
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Michele Gaffuri
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Luca Roncoroni
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Manuela Seia
- Medical Genetics Laboratory, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Felix C. Ringshausen
- Department of Respiratory Medicine, Hannover Medical School and German Center for Lung Research (DZL), Hannover, Germany
| | - Tobias Welte
- Department of Respiratory Medicine, Hannover Medical School and German Center for Lung Research (DZL), Hannover, Germany
| | - Francesco Blasi
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Stefano Aliberti
- Department of Pathophysiology and Transplantation, University of Milan, Internal Medicine Department, Respiratory unit and Adult Cystic Fibrosis Center, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - James D. Chalmers
- Division of Molecular and Clinical Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK
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22
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Idiopathic Scoliosis Families Highlight Actin-Based and Microtubule-Based Cellular Projections and Extracellular Matrix in Disease Etiology. G3-GENES GENOMES GENETICS 2018; 8:2663-2672. [PMID: 29930198 PMCID: PMC6071588 DOI: 10.1534/g3.118.200290] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Idiopathic scoliosis (IS) is a structural lateral spinal curvature of ≥10° that affects up to 3% of otherwise healthy children and can lead to life-long problems in severe cases. It is well-established that IS is a genetic disorder. Previous studies have identified genes that may contribute to the IS phenotype, but the overall genetic etiology of IS is not well understood. We used exome sequencing to study five multigenerational families with IS. Bioinformatic analyses identified unique and low frequency variants (minor allele frequency ≤5%) that were present in all sequenced members of the family. Across the five families, we identified a total of 270 variants with predicted functional consequences in 246 genes, and found that eight genes were shared by two families. We performed GO term enrichment analyses, with the hypothesis that certain functional annotations or pathways would be enriched in the 246 genes identified in our IS families. Using three complementary programs to complete these analyses, we identified enriched categories that include stereocilia and other actin-based cellular projections, cilia and other microtubule-based cellular projections, and the extracellular matrix (ECM). Our results suggest that there are multiple paths to IS and provide a foundation for future studies of IS pathogenesis.
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23
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Variations in vascular anatomy and unilateral adrenal agenesis in a female cadaver with situs inversus totalis. Surg Radiol Anat 2018; 40:1169-1172. [PMID: 29931532 DOI: 10.1007/s00276-018-2060-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 06/18/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE Situs inversus totalis is mirror transposition of thoracic and abdominal organs. Very few reports have been published on anatomic dissections of cadavers with this condition. METHODS This work describes a case of situs inversus totalis identified during the anatomical dissection of a 91-year-old woman. RESULTS Thoracic and abdominal viscera were inverted, but otherwise normal. The aorta originated from the right ventricle, which exhibited characteristics of the systemic ventricle. The pulmonary artery originated from the left ventricle, which had a tricuspid valve, three papillary muscles, thick trabeculae, a supraventricular crest, and septomarginal trabecula. The atrial situs was concordant with ventricular morphology. Lungs and paranasal sinuses were not suggestive of Kartagener's syndrome. Only the right adrenal gland was present, and variations in vascular anatomy were observed. The latter included: the celiac trunk branching into a phrenic artery, the splenic artery and a right gastric artery; the common hepatic artery originating from the superior mesenteric artery; and, on the left side, two inferior thyroid arteries, both originating from thyrocervical trunk. The occurrence of a double inferior thyroid artery and agenesis of adrenal gland was never communicated in situs inversus. Embryonic origin of celiac trunk and superior mesenteric artery variations could be explained by the separation at higher levels of the longitudinal anastomoses formed between the four roots of omphalomesenteric artery. CONCLUSION It can be hypothesized that this phenomenon could occur more frequently in situs inversus than in situs solitus. However, the number of cases investigated in such detail is too small to draw firm conclusions.
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24
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Goutaki M, Halbeisen FS, Spycher BD, Maurer E, Belle F, Amirav I, Behan L, Boon M, Carr S, Casaulta C, Clement A, Crowley S, Dell S, Ferkol T, Haarman EG, Karadag B, Knowles M, Koerner-Rettberg C, Leigh MW, Loebinger MR, Mazurek H, Morgan L, Nielsen KG, Phillipsen M, Sagel SD, Santamaria F, Schwerk N, Yiallouros P, Lucas JS, Kuehni CE. Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort. Eur Respir J 2017; 50:50/6/1701659. [PMID: 29269581 DOI: 10.1183/13993003.01659-2017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 09/15/2017] [Indexed: 01/02/2023]
Abstract
Chronic respiratory disease can affect growth and nutrition, which can influence lung function. We investigated height, body mass index (BMI), and lung function in patients with primary ciliary dyskinesia (PCD).In this study, based on the international PCD (iPCD) Cohort, we calculated z-scores for height and BMI using World Health Organization (WHO) and national growth references, and assessed associations with age, sex, country, diagnostic certainty, age at diagnosis, organ laterality and lung function in multilevel regression models that accounted for repeated measurements.We analysed 6402 measurements from 1609 iPCD Cohort patients. Height was reduced compared to WHO (z-score -0.12, 95% CI -0.17 to -0.06) and national references (z-score -0.27, 95% CI -0.33 to -0.21) in male and female patients in all age groups, with variation between countries. Height and BMI were higher in patients diagnosed earlier in life (p=0.026 and p<0.001, respectively) and closely associated with forced expiratory volume in 1 s and forced vital capacity z-scores (p<0.001).Our study indicates that both growth and nutrition are affected adversely in PCD patients from early life and are both strongly associated with lung function. If supported by longitudinal studies, these findings suggest that early diagnosis with multidisciplinary management and nutritional advice could improve growth and delay disease progression and lung function impairment in PCD.
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Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Florian S Halbeisen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Elisabeth Maurer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabiën Belle
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Laura Behan
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK.,School of Applied Psychology, University College Cork, Cork, Ireland
| | - Mieke Boon
- Dept of Paediatrics, University Hospital Gasthuisberg, Leuven, Belgium
| | - Siobhan Carr
- Primary Ciliary Dyskinesia Centre, Dept of Paediatrics, Royal Brompton and Harefield Foundation Trust, London, UK
| | | | | | - Suzanne Crowley
- Unit for Paediatric Heart, Lung, Allergic Diseases, Rikshospitalet, Oslo, Norway
| | - Sharon Dell
- Dept of Pediatrics, SickKids Hospital, University of Toronto, Toronto, Canada
| | - Thomas Ferkol
- Dept of Pediatrics, School of Medicine, Washington University, St Louis, MO, USA
| | - Eric G Haarman
- Dept of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands
| | - Bulent Karadag
- Dept of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Michael Knowles
- Dept of Medicine, Marsico Lung Institute, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Margaret W Leigh
- Dept of Pediatrics, Marsico Lung Institute, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Michael R Loebinger
- Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Henryk Mazurek
- Dept of Pneumonology and Cystic Fibrosis, Institute of Tuberculosis and Lung Disorders, Rabka-Zdrój, Poland
| | - Lucy Morgan
- Dept of Respiratory Medicine, Concord Hospital Clinical School, University of Sydney, Sydney, Australia
| | - Kim G Nielsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Phillipsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital, Copenhagen, Denmark
| | - Scott D Sagel
- Dept of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Nicolaus Schwerk
- Clinic for Paediatric Pulmonology, Allergiology and Neonatology, Hannover Medical School, Hannover, Germany
| | | | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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25
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Schlösser T, Brink R, Castelein R. THE ETIOLOGIC RELEVANCE OF 3-D PATHOANATOMY OF ADOLESCENT IDIOPATHIC SCOLIOSIS. COLUNA/COLUMNA 2017. [DOI: 10.1590/s1808-185120171604183510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Despite many years of dedicated research into the etiopathogenesis of adolescent idiopathic scoliosis, there is still no single distinct cause for this puzzling condition. In this overview, we attempt to link knowledge on the complex three-dimensional pathoanatomy of AIS, based on our ongoing research in this field, with etiopathogenic questions. Evidence from multiple recent cross-sectional imaging studies is provided that supports the hypothesis that AIS has an intrinsic biomechanical basis: an imbalance between the biomechanical loading of the upright human spine due to its unique sagittal configuration on the one hand, and the body’s compensating mechanisms on the other. The question that remains in the etiology of AIS, and the focus of our ongoing research, is to determine what causes or induces this imbalance.
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Affiliation(s)
| | - Rob Brink
- University Medical Center Utrecht, Netherlands
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26
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Schlösser TPC, Castelein RM. Reply to the Letter to the Editor of Zehao Jing et al. concerning "Scoliosis convexity and organ anatomy are related" by T. P. C. Schlösser et al. (Eur Spine J; 2017: doi: 10.1007/s00586-017-4970-5). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:521. [PMID: 28795256 DOI: 10.1007/s00586-017-5251-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 07/29/2017] [Indexed: 11/24/2022]
Affiliation(s)
- Tom P C Schlösser
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands.
| | - René M Castelein
- Department of Orthopaedic Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3508 GA, Utrecht, The Netherlands
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27
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Talic G, Talic L, Stevanovic-Papica D, Nozica-Radulovic T, Novakovic-Bursac S. The Effect of Adolescent Idiopathic Scoliosis on the Occurrence of Varicose Veins on Lower Extremities. Med Arch 2017; 71:107-109. [PMID: 28790540 PMCID: PMC5511530 DOI: 10.5455/medarh.2017.71.107-109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/15/2017] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Scoliosis is a complex three-dimensional spine deformity with the frontal plane deflexion (side-shift) of the series of vertebra from the midline and with torque deformity of vertebra, ribs, and the entire trunk towards the apex of curve. Chronic venous diseases present a group of pathological conditions caused by the increased venous pressure. The venous pressure may be increased due to genetics, ligament laxity, general obesity, injuries, and changes in biomechanics of spine and lower extremities, etc. AIM The aim of the study is to evaluate the frequency of the varicose veins in women previously treated for the adolescent idiopathic scoliosis. MATERIAL AND METHODS In the period August 1, 2015 - December 30, 2015 the Team for scoliosis in the Institute for the Physical medicine and Rehabilitation "Dr Miroslav Zotović" in Banja Luka in study program has clinically assessed 89 women previously treated for the adolescent idiopathic scoliosis (AIS) and the control group of 87 women without history of scoliosis. RESULTS Results of the study led to conclusion that occurrence of the varicose veins was more frequent in the group of women who were treated for the AIS (23/89 or 25.8%) in comparison with control group with no history of AIS (7/87 or 8.1%). CONCLUSION This might relate AIS with some other connective tissue disorder, like venous varices, for instance.
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Affiliation(s)
- Goran Talic
- Faculty of medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
- Institute of Physical Medicine and Rehabilitation „Dr Miroslav Zotović” Banja Luka, Bosnia and Herzegovina
| | - Luka Talic
- Faculty of medicine, University of Banja Luka, Banja Luka, Bosnia and Herzegovina
| | | | - Tatjana Nozica-Radulovic
- Institute of Physical Medicine and Rehabilitation „Dr Miroslav Zotović” Banja Luka, Bosnia and Herzegovina
| | - Snjezana Novakovic-Bursac
- Institute of Physical Medicine and Rehabilitation „Dr Miroslav Zotović” Banja Luka, Bosnia and Herzegovina
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