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Handa M, Demura S, Yokogawa N, Hinoi E, Hiraiwa M, Kato S, Shinmura K, Annen R, Kobayashi M, Yamada Y, Nagatani S, Kurokawa Y, Tsuchiya H. Characteristics of Scoliosis in Mice Induced by Chondrocyte-specific Inactivation of L-type Amino Acid Transporter 1. Spine (Phila Pa 1976) 2024; 49:285-293. [PMID: 37796156 DOI: 10.1097/brs.0000000000004842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/22/2023] [Indexed: 10/06/2023]
Abstract
STUDY DESIGN A mouse study of the Slc7a5 gene using conditional knockout to assess the effects of its inactivation on spinal deformity. OBJECTIVES This study aimed to investigate whether the mice with scoliosis [induced by chondrocyte-specific inactivation of L-type amino acid transporter 1 (LAT1)] show a developmental process similar to that of pediatric scoliosis and to examine the relationship between reduced bone mineral density (BMD) and scoliosis. Furthermore, we aimed to obtain insights into elucidating the etiology and pathophysiology of scoliosis. SUMMARY OF BACKGROUND DATA The etiology and pathogenesis of scoliosis are not fully understood despite substantial investigative efforts. LAT1 is an amino acid transporter that mediates the cellular uptake of large neutral amino acids. A recent study revealed that chondrocyte-specific inactivation of LAT1 in mice results in scoliosis (Col2a1-Cre;Slc7a5fl/fl mice: "Sko mice"). MATERIALS AND METHODS Body length, body weight, Cobb angle, vertebral body rotation angle, and BMD at 1, 2, 4, 6, and 8 weeks of age were examined and statistically compared with those of normal control mice. Pathologic and morphologic evaluation was performed on specimens from 10-week-old euthanized mice. RESULTS The Sko mice developed thoracic scoliosis in infancy without congenital malformations. This spinal deformity progressed rapidly during growth, with diverse curve patterns and hypoplastic vertebral bodies. Pathologic examination revealed thickening of the growth plates and decreased osteoblasts, suggesting that impaired endochondral ossification was the cause of the scoliosis. Sko mice were also observed to have decreased BMD and degraded bone microstructure. Reduced BMD and bone quality may not be the causes of the onset and progression of scoliosis in the Sko mice. CONCLUSIONS In Sko mice, the characteristics of scoliosis and vertebral pathology showed many similarities with syndromic scoliosis in humans. Endochondral ossification defects may impair growth, leading to scoliosis and decreased BMD.
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Affiliation(s)
- Makoto Handa
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Satoru Demura
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Noriaki Yokogawa
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Eiichi Hinoi
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Manami Hiraiwa
- Department of Bioactive Molecules, Pharmacology, Gifu Pharmaceutical University, Gifu, Japan
| | - Satoshi Kato
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Kazuya Shinmura
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Ryohei Annen
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Motoya Kobayashi
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yohei Yamada
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Satoshi Nagatani
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Yuki Kurokawa
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
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Cheng Y, Yang H, Hai Y, Pan A, Zhang Y, Zhou L. Hounsfield unit for assessing asymmetrical loss of vertebral bone mineral density and its correlation with curve severity in adolescent idiopathic scoliosis. Front Surg 2022; 9:1000031. [PMID: 36211282 PMCID: PMC9535087 DOI: 10.3389/fsurg.2022.1000031] [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: 07/21/2022] [Accepted: 08/31/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundLow bone mass concomitantly occurs in patients with adolescent idiopathic scoliosis (AIS) and can persist until skeletal maturity. The purpose of this study was to assess the asymmetrical loss of vertebral bone mineral density (vBMD) and its correlation with curve severity in patients with AIS using Hounsfield unit (HU) values measured from computed tomography scans.MethodsA total of 93 AIS patients were retrospectively recruited. The HU values of the vertebral body (VB-HU) and pedicle screw trajectory (PST-HU) were measured from four vertebrae above (Apex − 4) to four below (Apex + 4) the apical vertebra (Apex) of the major curve. The VB-HU and PST-HU at the upper end vertebra, Apex, and lower end vertebra within the concave and convex sides of the major and minor curves and stable vertebrae were obtained.ResultsA significant correlation was found between the Cobb angle and VB-HU at the periapical levels of the major curve. VB-HU and PST-HU at periapical levels were significantly greater within the concavity than the convexity of both major and minor curves. The asymmetric ratios of VB-HU and PST-HU were significantly correlated with the major curve Cobb angle, peaked at the apex, and gradually diminished from the apex to the end vertebrae. The asymmetrical loss of vBMD aggravated with the progression of curve severity, presenting as VB-HU, significantly decreased within the convexity and insignificantly decreased within the concavity of the major curve.ConclusionThe asymmetrical loss of vBMD was associated with the progression of curve severity in AIS. For patients with severe AIS, the distraction of the pedicle screws at the concave side should be a priority in correcting the major curve, and supplemental anchors and larger-sized screws should be placed within the convex side around the apex of the major curve to reduce the risk of screw loosening after surgery.
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Affiliation(s)
| | | | - Yong Hai
- Correspondence: Yong Hai , Lijin Zhou
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Zhang C, Wang Y, Yu J, Jin F, Zhang Y, Zhao Y, Fu Y, Zhang K, Wang J, Dai L, Gao M, Li Z, Wang L, Li X, Wang H. Analysis of sagittal curvature and its influencing factors in adolescent idiopathic scoliosis. Medicine (Baltimore) 2021; 100:e26274. [PMID: 34115026 PMCID: PMC8202640 DOI: 10.1097/md.0000000000026274] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 03/20/2021] [Accepted: 05/24/2021] [Indexed: 01/04/2023] Open
Abstract
ABSTRACT This study aimed to explore the characteristics of changes in the sagittal arrangement of the spine between adolescent patients with idiopathic scoliosis (AIS) and normal adolescents, the risk factors for AIS and the factors affecting the progress of AIS.X-ray images of the full length of the spine in standing position were taken in AIS patients and normal adolescents. Radiographic measurements made at intermediate follow-up included the following:C1 and C2 cervical lordosis and C2 - C7 curvature of cervical lordosis, C2-C7sagittal horizontal distance (C2-C7SagittalVerticalAxis, C2-C7SVA), TS-CL, after thoracic lobe (Thoracic Kyphosis, TK), thoracic lumbar segment Angle (thoracolumbar kyphosis, [TLK]), lumbar lordosis Angle (Lumbar Lordosis, LL), sacral slope Angle (Sacrum Slope, SS), pelvic tilt Angle (Pelvic Tilt, PT), pelvic incidence (PI), L5 Incidence (Lumbar5 Slope (L5S), L5 incidence (Lumbar5 Incidence (L5I), sagittal horizontal distance (CSVA), lower depression Angle of the 2nd cervical spine. The difference of sagittal plane parameters between AIS group and normal adolescent group was compared. To evaluate the progress of AIS, correlation analysis was conducted between diagonal 2 and other parameters. The main risk factors of AIS were determined by binary Logistic analysis.The CSVA of AIS patients was higher than that of healthy adolescents (AIS: 27.64 ± 19.56) mm. Healthy adolescents: (17.74 ± 12.8) mm), L5S (AIS: 19.93°= 7.07° and healthy adolescents: 15.38°= 7.78°, P = .024 < .05), C2 downward sag Angle (AIS: 15.12°= 2.7°;Healthy adolescents: 12.97°= 4.56°); AIS patients had lower TS-CL (AIS: 22.48 ± 6.09 and healthy adolescents: 28.26°= 10.32°), PT (AIS: 10.42°= 4.53° and healthy adolescents: 15.80°=7.68°), (AIS: 41.87°=9.72° and healthy adolescents: 48.75°= 8.22°). The main risk factor for idiopathic scoliosis in adolescents was L5 (OR = 1.239, 95%CI = 1.049-1.463, P = .012 < .05).L5S is a major risk factor for idiopathic scoliosis in adolescents. The larger PI is, the higher the risk of scoliosis progression is. In AIS patients, lumbar lordosis is increased, cervical lordosis is reduced, and even cervical kyphosis occurs.
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Affiliation(s)
- Cong Zhang
- The First Clinical College of Inner Mongolia Medical University
| | - Yidan Wang
- Department of Postgraduates, Inner Mongolia Medical University
| | - Jinghong Yu
- Department of Medical imaging, The Second Affiliated Hospital of Inner Mongolia Medical University
| | - Feng Jin
- Department of Medical imaging, The First Affiliated Hospital of Inner Mongolia Medical University
| | - Yunfeng Zhang
- Department of Medical imaging, The Second Affiliated Hospital of Inner Mongolia Medical University
| | - Yan Zhao
- Department of Spine Surgeon, The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot
| | - Yu Fu
- Department of Spine Surgeon, The Second Affiliated Hospital of Inner Mongolia Medical University, Huhhot
| | - Kai Zhang
- The Second Hospital of Ulanqab, Ulanqab
| | - Jianzhong Wang
- Department of Anatomy, Inner Mongolia Medical University
| | - Lina Dai
- Department of Anatomy, Inner Mongolia Medical University
| | - Mingjie Gao
- Department of Postgraduates, Inner Mongolia Medical University
- Department of Anatomy, Inner Mongolia Medical University
| | - Zhijun Li
- Department of Anatomy, Inner Mongolia Medical University
| | - Lidong Wang
- Department of Medical imaging, Inner Mongolia International Mongolian Medical Hospital, Huhhot, China
| | - Xiaohe Li
- Department of Anatomy, Inner Mongolia Medical University
| | - Haiyan Wang
- Department of Anatomy, Inner Mongolia Medical University
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Zhang J, Cheuk KY, Xu L, Wang Y, Feng Z, Sit T, Cheng KL, Nepotchatykh E, Lam TP, Liu Z, Hung AL, Zhu Z, Moreau A, Cheng JC, Qiu Y, Lee WY. A validated composite model to predict risk of curve progression in adolescent idiopathic scoliosis. EClinicalMedicine 2020; 18:100236. [PMID: 31922123 PMCID: PMC6948250 DOI: 10.1016/j.eclinm.2019.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND In adolescent idiopathic scoliosis (AIS), the continuous search for effective prognostication of significant curve progression at the initial clinical consultation to inform decision for timely treatment and to avoid unnecessary overtreatment remains a big challenge as evidence of the multifactorial etiopathogenic nature is increasingly reported. This study aimed to formulate a composite model composed of clinical parameters and circulating markers in the prediction of curve progression. METHOD This is a two-phase study consisting of an exploration cohort (120 AIS, mean Cobb angle of 25°± 8.5 at their first clinical visit) and a validation cohort (51 AIS, mean Cobb angle of 23° ± 5.0° at the first visit). Patients with AIS were followed-up for a minimum of six years to formulate a composite model for prediction. At the first visit, clinical parameters were collected from routine clinical practice, and circulating markers were assayed from blood. FINDING We constructed the composite predictive model for curve progression to severe Cobb angle > 40° with a high HR of 27.9 (95% CI of 6.55 to 119.16). The area under curve of the composite model is higher than that of individual parameters used in current clinical practice. The model was validated by an independent cohort and achieved a sensitivity of 72.7% and a specificity of 90%. INTERPRETATION This is the first study proposing and validating a prognostic composite model consisting of clinical and circulating parameters which could quantitatively evaluate the probability of curve progression to a severe curvature in AIS at the initial consultation. Further validation in clinic will facilitate application of composite model in assisting objective clinical decision.
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Affiliation(s)
- Jiajun Zhang
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ka-yee Cheuk
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Leilei Xu
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Yujia Wang
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Zhenhua Feng
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Tony Sit
- Department of Statistics, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Ka-lo Cheng
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Evguenia Nepotchatykh
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
| | - Tsz-ping Lam
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Zhen Liu
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Alec L.H. Hung
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Zezhang Zhu
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
| | - Alain Moreau
- Viscogliosi Laboratory in Molecular Genetics of Musculoskeletal Diseases, Sainte-Justine University Hospital Research Center, Montreal, QC, Canada
- Department of Stomatology, Faculty of Dentistry, Université de Montréal, Montreal, QC, Canada
- Department of Biochemistry and Molecular Medicine, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Jack C.Y. Cheng
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Co-corresponding author at: Lui Che Woo Clinical Science Bu/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, Hong Kong, China.
| | - Yong Qiu
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China
- Co-corresponding author at: Spine Surgery, Nanjing Drum Tower Hospital, Nanjing, China.
| | - Wayne Y.W. Lee
- Department of Orthopaedics and Traumatology, SH Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Joint Scoliosis Research Centre of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Corresponding author at: Room 904, 9/F, Li Ka Shing Medical Sciences Building, Prince of Wales Hospital, Shatin, Hong Kong, China.
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Chen H, Zhang J, Wang Y, Cheuk KY, Hung ALH, Lam TP, Qiu Y, Feng JQ, Lee WYW, Cheng JCY. Abnormal lacuno-canalicular network and negative correlation between serum osteocalcin and Cobb angle indicate abnormal osteocyte function in adolescent idiopathic scoliosis. FASEB J 2019; 33:13882-13892. [PMID: 31626573 PMCID: PMC6894095 DOI: 10.1096/fj.201901227r] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/10/2019] [Indexed: 12/28/2022]
Abstract
Adolescent idiopathic scoliosis (AIS) is a prevalent spinal deformity occurring during peripubertal growth period that affects 1-4% of adolescents globally without clear etiopathogenetic mechanism. Low bone mineral density is an independent and significant prognostic factor for curve progression. Currently, the cause underlying low bone mass in AIS remains elusive. Osteocytes play an important role in bone metabolism and mineral homeostasis, but its role in AIS has not been studied. In the present study, iliac bone tissues were harvested from 21 patients with AIS (mean age of 14.3 ± 2.20 yr old) with a mean Cobb angle of 55.6 ± 10.61° and 13 non-AIS controls (mean age of 16.5 ± 4.79 yr old) intraoperatively. Acid-etched scanning electron microscopy (SEM) images of AIS demonstrated abnormal osteocytes that were more rounded and cobblestone-like in shape and were aligned in irregular clusters with shorter and disorganized canaliculi. Further quantitative analysis with FITC-Imaris technique showed a significant reduction in the canalicular number and length as well as an increase in lacunar volume and area in AIS. SEM with energy-dispersive X-ray spectroscopy analysis demonstrated a lower calcium-to-phosphorus ratio at the perilacunar/canalicular region. Moreover, microindentaion results revealed lower values of Vickers hardness and elastic modulus in AIS when compared with controls. In addition, in the parallel study of 99 AIS (27 with severe Cobb angle of 65.8 ± 14.1° and 72 with mild Cobb angle of 26.6 ± 9.1°) with different curve severity, the serum osteocalcin level was found to be significantly and negatively associated with the Cobb angle. In summary, the findings in this series of studies demonstrated the potential link of abnormal osteocyte lacuno-canalicular network structure and function to the observed abnormal bone mineralization in AIS, which may shed light on etiopathogenesis of AIS.-Chen, H., Zhang, J., Wang, Y., Cheuk, K.-Y., Hung, A. L. H., Lam, T.-P., Qiu, Y., Feng, J. Q., Lee, W. Y. W., Cheng, J. C. Y. Abnormal lacuno-canalicular network and negative correlation between serum osteocalcin and Cobb angle indicate abnormal osteocyte function in adolescent idiopathic scoliosis.
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Affiliation(s)
- Huanxiong Chen
- Department of Spine and Osteopathic Surgery, The
First Affiliated Hospital of Hainan Medical University, Hai-kou, China
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Jiajun Zhang
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Yujia Wang
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Ka-Yee Cheuk
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Alec L. H. Hung
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Tsz-Ping Lam
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Yong Qiu
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
- Spine Surgery, Nanjing Drum Tower Hospital,
Nanjing University, Nanjing, China
| | - Jian Q. Feng
- Department of Biomedical Sciences, Texas
A&M College of Dentistry, Dallas, Texas, USA
| | - Wayne Y. W. Lee
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
| | - Jack C. Y. Cheng
- Department of Orthopaedics and Traumatology, S. H.
Ho Scoliosis Research Laboratory, The Chinese University of Hong Kong, Shatin, NT,
Hong Kong, China
- Joint Scoliosis Research Center of The Chinese
University of Hong Kong–Nanjing University, The Chinese University of Hong
Kong, Hong Kong, China
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Xu E, Lin T, Jiang H, Ji Z, Shao W, Meng Y, Gao R, Zhou X. Asymmetric expression of GPR126 in the convex/concave side of the spine is associated with spinal skeletal malformation in adolescent idiopathic scoliosis population. 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 2019; 28:1977-1986. [DOI: 10.1007/s00586-019-06001-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/24/2019] [Accepted: 05/05/2019] [Indexed: 12/24/2022]
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