Abstract
Asymmetrical growth of the vertebrae has been implicated as one possible etiologic factor in the pathogenesis of adolescent idiopathic scoliosis. The longitudinal vertebral growth derives from the endochondral ossification of the vertebral growth plate. In the present study, the growth plates from the convex and concave side of the vertebrae were characterized by the method of histology and immunohistochemistry to evaluate the growth activity, cell proliferation, and apoptosis. Normal zoned architectures were observed in the convex side of the growth plate and disorganized architectures in the concave side. The histological grades were significantly different between the convex and the concave side of the growth plate in the apex vertebrae (P < 0.05). The histological difference was also found significant statistically between end vertebrae and apex vertebrae in the concave side of vertebral growth plates (P < 0.05). The proliferative potential indexes and apoptosis indexes of chondrocytes in the proliferative and hypertrophic zone in the convex side were significantly higher than that in the concave side in the apex vertebral growth plate (P < 0.05). There was a significant difference of the proliferative potential index (proliferating cell nuclear antigen, PCNA index) between convex side and concave side at the upper end vertebra (P < 0.05). The difference of the proliferative potential index and apoptosis index were found significant statistically in the concave side of the vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). The same result was also found for the apoptosis index (terminal deoxynucleotidyl transferase mediated deoxyuridine triphosphate biotin nick end labeling assay, TUNEL index) in the convex side of vertebral growth plate between end vertebrae and apex vertebrae (P < 0.05). Some correlation were found between radiographic measurements and proliferation and apoptosis indexes. The difference in histological grades and cellular activity between the convex and concave side indicated that the bilateral growth plate of the vertebrae in AIS patients have different growth kinetics which may affect the curve progression.
Highlights
Adolescent idiopathic scoliosis (AIS) is a complex threedimensional anomaly of the spine which involves lateral deviations on the frontal plane, misalignment on the sagittal plane, and spinal torsion
Clinical data and tissue sampling From November 2004 to April 2006, the samples of vertebral growth plates were harvested from patients with idiopathic scoliosis who underwent anterior release and fusion for thoracic, lumbar, or thoracolumbar curves
Histological grades Each of the growth plates were first stained with hematoxylin and eosin
Summary
Adolescent idiopathic scoliosis (AIS) is a complex threedimensional anomaly of the spine which involves lateral deviations on the frontal plane, misalignment on the sagittal plane, and spinal torsion. Some research even reported that differential growth rates between the right and left side of the vertebrae could generate asymmetric growth and wedging of the vertebrae which may play an important role in the progression of the curve [4,5,6,7,8]. A large scale of scoliotic specimens was studied by Parent et al.[9] They found that vertebral wedging was more prominent in the frontal plane, and there was minimal wedging in the sagittal plane. The clinical observation that the vertebral height on the concave side in the curve was smaller than that of the convex side makes us believe that vertebral asymmetric growth in the frontal plane plays a more important role in the progression of idiopathic scoliosis
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