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Abnormal bone quality in adolescent idiopathic scoliosis: a case-control study on 635 subjects and 269 normal controls with bone densitometry and quantitative ultrasound

STUDY DESIGN: A case-control study comparing bone quality in Adolescent Idiopathic Scoliosis (AIS) with normal controls. OBJECTIVE: To evaluate bone quality with quantitative ultrasound (QUS) in AIS and normal controls so as to detect any derangement in bone quality among AIS subjects. SUMMARY OF BACKGROUND DATA: AIS is characterized by complex spinal deformities. Despite its high prevalence and clinical impact in adolescents, etiology of AIS remains unknown but one possible mechanism is related to derangement of bony mechanical stability, as quantified by bone mineral density (BMD) and bone quality. AIS is known for its association with osteopenia, but little is known about the bone quality in AIS. With technological advancement, QUS can provide objective measurement of bone quality. In this study, we sought to compare bone quality in AIS with normal controls using QUS in addition to the conventional BMD measurement. METHODS: Six hundred thirty-five AIS girls and 269 age-matched normal girls were investigated. Broadband ultrasound attenuation (BUA), velocity of sound (VOS), and stiffness index (SI) were measured over the nondominant calcaneus using QUS. The results were correlated with anthropometric measurement, radiologic assessment, and BMD of both hips. RESULTS: The z-score of BMD at the femoral neck of AIS subjects (-0.47 +/- 0.97) was significantly lower than that of normal controls (-0.12 +/- 1.01, P < 0.001). Crude comparison showed that BUA, VOS, and SI of AIS group were 3.8% (P < 0.01), 0.5% (P = 0.042), and 6.9% (P < 0.01) lower than controls, respectively. After controlling confounding from maturity, body weight, body height, and BMD with multiple linear regression analysis for both mild (Cobb's angle 25 degrees ) curves, BUA and SI were found to be statistically significantly lower in AIS as compared with controls (P < 0.05). CONCLUSION: In addition to higher prevalence of osteopenia, AIS patients were also found to have deranged bone quality. These might contribute to the etiopathogenesis of spinal deformities in AIS Keywords : Absorptiometry,Photon,Adolescent,analysis,Body Height,Body Weight,Bone and Bones,Bone Density,Case-Control Studies,Child,China,diagnostic imaging,etiology,Female,Femur Neck,Hip,Humans,Linear Models,methods,Multivariate Analysis,Neck,Patients,Prevalence,Regression Analysis,Scoliosis,Traumatology,Ultrasonography,Universities,, Bone,Quality,Adolescent,Idiopathic, best migraine clinic

Date of Publication : 2011 Jul 1

Authors : Lam TP;Hung VW;Yeung HY;Tse YK;Chu WC;Ng BK;Lee KM;Qin L;Cheng JC;

Organisation : Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong, SAR, China

Journal of Publication : Spine (Phila Pa 1976 )

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21217455

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Abnormal bone quality in adolescent idiopathic scoliosis a case-control study on 635 subjects and 269 normal controls with bone densitometry and quantitative ultrasound | Botox nerve damage

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