Bony Growth Research Articles

CCR7 depletion alleviates bony growth imbalance following physeal injury in mice

Growth plates are the frequent sites of skeletal injury in children, leading to skeletal growth imbalances. Chemokines, including the receptor CCR7, play a crucial role in stem cell recruitment and cartilage homeostasis, with previous studies linking CCR7 to osteoarthritis progression. However, its role in growth plate cartilage remains unclear. We analyzed the role of CCR7 in the physeal cartilage repair process in mice model. Physeal injury was created in the proximal tibia in 3-week-old C57BL/6 mice (WT) and CCR7-knockout mice (CCR7−/−). Tibial length was measured macroscopically and sections of the physeal injury were analyzed histologically and immunohistochemically. Height and bone volume of the tibial growth plate and bone mineral density (BMD) of the subchondral area were measured by micro-CT. Mesenchymal stem cells (MSCs) were harvested and gene expression after osteogenic differentiation was analyzed using qRT-PCR. At 1, 3 and 5 weeks postoperatively, injured tibiae of CCR7−/− mice were less shortened than those of WT mice. Bone volume of the physeal bridge was significantly lower in CCR7−/− mice than in WT mice. In contrast, BMD of the subchondral area was comparable between CCR−/− and WT mice, and between sham and operated tibiae. In osteogenic differentiation, CCR7−/− mice showed significantly lowered expression of osteogenic markers such as Osterix, Runx2 and Type X collagen. We demonstrated CCR7 depletion in mice inhibited physeal bridge formation and ameliorated growth imbalances after physeal injury.

A novel strain-based bone-fracture healing algorithm is able to predict a range of healing outcomes

Fracture healing is a complex process which sometimes results in non-unions, leading to prolonged disability and high morbidity. Traditional methods of optimising fracture treatments, such as in vitro benchtop testing and in vivo randomised controlled trials, face limitations, particularly in evaluating the entire healing process. This study introduces a novel, strain-based fracture-healing algorithm designed to predict a wide range of healing outcomes, including both successful unions and non-unions. The algorithm uses principal strains as mechanical stimuli to simulate fracture healing in response to local mechanical environments within the callus region. The model demonstrates good agreement with experimental data from ovine metatarsal osteotomies across six fracture cases with varying gap widths and inter-fragmentary strains, replicates physiological bony growth patterns, and is independent of the initial callus geometry. This computational approach provides a framework for developing new fracture-fixation devices, aid in pre-surgical planning, and optimise rehabilitation strategies.

Osteochondroma of the Distal Tibia in an Adolescent: A Case Report

A 17-year-old male presented with a painful left ankle that had been worsening over the preceding 1 year. Clinical and radiographic inspection revealed marked bowing with a deformation of the fibula secondary to the laterally outgrowing bone lesion from the distal tibia proximal to the growth plate. MRI appearance suggestive of an osteochondroma of the lower extremity of the left tibia with signs of degeneration, It is surrounded by a cartilaginous cap, thickened in places, measuring 22 mm in maximum thickness. Although the radiographic characteristics of the lesion were indicative of osteochondroma, a typically asymptomatic and benign tumor that is usually identified as an incidental finding, the large size and symptoms associated with the lesion described in this article make it rather unusual. In this particular case, excessive bony outgrowth, pain, joint malposition, necessitated surgical intervention. The patient was successfully treated with resection of the tumor, after which gradual restoration of the alignment of the distal leg ensued without the need for fibular osteotomy. After more than 1 year of postoperative follow-up, neither radiographic nor clinical evidence of recurrence had been observed and the patient displayed a pain-free range of ankle motion without any physical limitations.

Development of a chronic compression spinal cord injury model in neonatal and adult rats.

Spinal cord injury presents a significant burden globally, with traumatic spinal cord injury being the predominant cause historically. However, nontraumatic spinal cord injury (NTSCI) is emerging as a significant contributor, particularly in developed nations, yet it remains poorly understood due to underreporting and misclassification. NTSCI, spanning various etiologies such as bony growths, vascular conditions, infections, neoplastic conditions, and immune disorders, poses unique challenges in diagnosis and treatment, often resulting in lifelong morbidity. This study addresses the lack of suitable animal models for NTSCI research, especially in neonatal animals. Utilizing a solid spacer approach, we developed a compression NTSCI model applicable to both neonatal and adult Sprague-Dawley rats. Through anatomical measurements and invivo experiments, we confirmed the feasibility and safety of the spacer insertion procedure and observed no acute off-target effects. The versatility of this model lies in its adaptability to different ages of rats, offering a cost-effective and reproducible means to induce graded injuries. Moreover, behavioral assessments demonstrated observable hindlimb function, validating the model's utility for studying functional outcomes. Although challenges persist, particularly in accounting for spinal column growth in neonatal animals, this model fills a crucial gap in pediatric NTSCI research. By providing a platform to investigate pathophysiological mechanisms and test potential treatments, it offers promising avenues for advancing our understanding and management of pediatric NTSCI.

Morphometry of the Foramen Ovale in Adult Human Skulls from a Clinical Perspective.

The foramen ovale is present in the posterior part of the greater wing of sphenoid. A trauma or space-occupying lesion in this area would result in clinical manifestations due to compression of the structures passing through it. This study was undertaken because of the clinical significance of the foramen ovale in radiological and neurological procedures. The aim is to study the morphometry of the foramen ovale and its bilateral variations. Fifty adult dry human skulls of unknown age and sex were studied. The shape of the foramen ovale (FO), presence of accessory foramina or abnormal bony outgrowths, if any, were noted. Maximum length and width of FO were measured. The foramen ovale was present bilaterally in all 50 skulls. Accessory foramen was present in 17 (34%) and 13 (26%) skulls on the right and left side, respectively. Bony out growths were present in 9 (18%) and 15 (30%) skulls on the right and the left side, respectively. Understanding the exact topography, morphometry and variations of the FO is required to enable the clinician to correctly interpret radiographs and help in planning the surgical procedures. The findings presented here should be taken into account when neurological procedures of the middle cranial fossa are performed.

A very handy spine!

Behind the retro auricular groove, hidden by the pinna, on the surface of the mastoid, there is, a bony outgrowth, known by any otorhinolaryngologist worthy of the name, located above and behind the entrance to the external auditory canal in front of the supra meatic fossa: Henle's spine. In this historical note the authors retrace the moment of the dicovery of this primordial relief of otological surgery and the life of its discoverer, the German anatomis Jakob Henle, a true malesrtom which mixes science, art politics, and love.

Oral Tori Findings in an Adult Albanian Population: A Single-Center Pilot Study.

Tori are bony growths in the mouth caused by genetic and environmental factors. Oral tori may grow over time and interfere with oral hygiene, speech, mastication, and the application of dentures. The aim of this study was to evaluate the prevalence and patterns of torus mandibularis and torus palatinus according to age and gender among people in Albania. A single-center pilot study was conducted at Diamond Dental Hospital (DDH) from 1 February to 30 April 2024 in Tirana, Albania. Written consent was obtained from each participant. The patients were interviewed by one trained researcher and examined intraorally by one experienced examiner. Photographs were taken of any positive findings. The prevalence of oral tori in this sample from Albania was very high at 48%, and the peak incidence was in the 18-29 age group (54%). The most common type was torus mandibularis, with a prevalence of 39%. The most prevalent form of torus palatinus was flat (71%) and of torus mandibularis was solitary bilateral (48%). This single-center pilot study found a high prevalence of oral tori among people in Tirana, Albania. Its prevalence was not related to gender or bruxism. Dental professionals should note the high occurrence of oral tori and their importance in dental practice.

A three-dimensional quantitative assessment on bony growth and symmetrical recovery of mandible after decompression for unicystic ameloblastoma

Unicystic ameloblastoma (UAM) of the jaw can be effectively reduced in volume through decompression, which promotes bone regeneration and restores jaw symmetry. This study quantitatively evaluated changes in mandible volume and symmetry following decompression of mandibular UAM. This study included 17 patients who underwent surgical decompression followed by second-stage curettage for mandibular UAM. Preoperative and postoperative three-dimensional computed tomography (CT) images were collected. Bone volume and the area of cortical perforation were measured to assess bone growth during decompression. Mandibular volumetric symmetry was analyzed by calculating the volumetric ratio of the two sides of the mandible. Twelve pairs of landmarks were identified on the surface of the lesion regions, and their coordinates were used to calculate the mean asymmetry index (AI) of the mandible. Paired t-tests and the Mann–Whitney U test were used for statistical analysis, with p < 0.05 considered indicative of statistical significance. The mean duration of decompression was 9.41 ± 3.28 months. The mean bone volume increased by 8.07 ± 2.41%, and cortical perforation recovery was 71.97 ± 14.99%. The volumetric symmetry of the mandible improved significantly (p < 0.05), and a statistically significant decrease in AI was observed (p < 0.05). In conclusion, UAM decompression enhances bone growth and symmetry recovery of the mandible. The present evaluation technique is clinically useful for quantitatively assessing mandibular asymmetry.

Views about the clinical, diagnostic and comprehensive treatment of plantar fasciitis: a review

INTRODUCTION. One of the problems in modern podiatry is plantar fasciitis. According to population studies, more than two million patients are treated for plantar fasciitis each year in the United States, 1 in 10 people will develop heel pain during their lifetime, and 1 % of visits to podiatrists are related to heel pain. Plantar fasciitis occurs in approximately 10 % of the general population, with 83 % of these patients being active working adults between the ages of 25 and 65. The high prevalence of plantar fasciitis in the population necessitates the search and development of new and effective methods for its recognition and treatment. AIM. Generalization of literature data on the mechanisms of development of plantar fasciitis, methods of diagnosis and treatment. MATERIALS AND METHODS. The databases PubMed, Scopus and the electronic scientific library eLIBRARY were searched for articles using the keywords: “plantar fasciitis”, “plantar fasciosis”, “heel pain”, “heel spur”. Search depth — 10 years. Publications related to the diagnosis and treatment of PF were selected. During the study, 40 publications were selected, the content of which, to one degree or another, corresponded to the purpose of this study. RESULTS AND DISCUSSION. Pain syndrome in the area of the heel bone is the main reason for seeking medical care in patients with plantar fasciitis. Currently, there are several approaches to the treatment of plantar fasciitis: conservative and surgical treatment. Conservative treatment is represented by methods of manual therapy, physical therapy, and physical therapy. Surgical methods include various variants of resection of the bony outgrowth of the calcaneal region and other interventions. CONCLUSION. Treatment of plantar fasciitis requires a multidisciplinary approach to treatment, as no single treatment method is universal. Conservative treatment of patients with plantar fasciitis should be comprehensive. Due to the high prevalence of plantar fasciitis in the population, the introduction of new treatment techniques and the development and use of a unified patient management tactic can improve patient outcomes and quality of life. Among other surgical methods, the use of RFD has a positive effect in patients with PF refractory to conservative therapy and is the least invasive method among surgical methods.

Advanced MRI metrics improve the prediction of baseline disease severity for individuals with degenerative cervical myelopathy

BACKGROUND CONTEXTDegenerative cervical myelopathy (DCM) is the most common form of atraumatic spinal cord injury globally. Degeneration of spinal discs, bony osteophyte growth and ligament pathology results in physical compression of the spinal cord contributing to damage of white matter tracts and grey matter cellular populations. This results in an insidious neurological and functional decline in patients which can lead to paralysis. Magnetic resonance imaging (MRI) confirms the diagnosis of DCM and is a prerequisite to surgical intervention, the only known treatment for this disorder. Unfortunately, there is a weak correlation between features of current commonly acquired MRI scans (“community MRI, cMRI”) and the degree of disability experienced by a patient. PURPOSEThis study examines the predictive ability of current MRI sequences relative to “advanced MRI” (aMRI) metrics designed to detect evidence of spinal cord injury secondary to degenerative myelopathy. We hypothesize that the utilization of higher fidelity aMRI scans will increase the effectiveness of machine learning models predicting DCM severity and may ultimately lead to a more efficient protocol for identifying patients in need of surgical intervention. STUDY DESIGN/SETTINGSingle institution analysis of imaging registry of patients with DCM. PATIENT SAMPLEA total of 296 patients in the cMRI group and 228 patients in the aMRI group. OUTCOME MEASURESPhysiologic measures: accuracy of machine learning algorithms to detect severity of DCM assessed clinically based on the modified Japanese Orthopedic Association (mJOA) scale. METHODSPatients enrolled in the Canadian Spine Outcomes Research Network registry with DCM were screened and 296 cervical spine MRIs acquired in cMRI were compared with 228 aMRI acquisitions. aMRI acquisitions consisted of diffusion tensor imaging, magnetization transfer, T2-weighted, and T2*-weighted images. The cMRI group consisted of only T2-weighted MRI scans. Various machine learning models were applied to both MRI groups to assess accuracy of prediction of baseline disease severity assessed clinically using the mJOA scale for cervical myelopathy. RESULTSThrough the utilization of Random Forest Classifiers, disease severity was predicted with 41.8% accuracy in cMRI scans and 73.3% in the aMRI scans. Across different predictive model variations tested, the aMRI scans consistently produced higher prediction accuracies compared to the cMRI counterparts. CONCLUSIONSaMRI metrics perform better in machine learning models at predicting disease severity of patients with DCM. Continued work is needed to refine these models and address DCM severity class imbalance concerns, ultimately improving model confidence for clinical implementation.

Does sacral ratio have any impact on success rate of biofeedback therapy in children with lower urinary tract dysfunction?

To evaluate the possible impact of patients' sacral ratios (SRs) on response to biofeedback (BF) therapy in pediatric patients with lower urinary tract dysfunction (LUTD). In this retrospective cohort conducted from 2016 to 2018 in our tertiary medical center, we included the medical records of all pediatric patients with LUTD who were nominated for BF due to having abnormal uroflowmetry patterns and simultaneous increase in electromyography (EMG) activity. Ten sessions of weekly animated BF were performed for each patient. All patients underwent a complete urological evaluation, uroflowmetry with simultaneous EMG and post-void residual measurement before and after treatment. SRs were calculated based on plain anteroposterior lumbosacral radiographs. Patients were then divided into normal SR (≥0.74) and low SR (<0.74) and outcomes were compared between them. Of the total 86 patients included in our study, 48 (55.8%) had a normal SR (≥0.74), while 38 (44.2%) had a low SR (<0.74). Our data revealed that BF therapy significantly improved maximum and average urinary flow rates, urine volume, daytime urinary incontinence, enuresis, urinary urgency and constipation; irrespective of the patients' SRs (all P<0.001). Our between-groups analyses showed that after the completion of BF, the SR≥0.74 group had significantly higher maximum urinary flow rate (mean difference [95%CI]: 7.7 [5.4, 10.0], P<0.001) (Figure) and urine volume (mean difference [95%CI]: 49.9 [19.5, 80.4], P=0.002) and significantly lower diurnal urinary incontinence (4.2% vs. 21.1%, P=0.020), enuresis (4.2% vs. 18.4%, P=0.040) and constipation (2.1% vs. 23.7%, P=0.004) compared to the SR<0.74 group. SR has been proposed as a reliable indicator of bony pelvis growth and subsequent lumbosacral neurodevelopment. Additionally, larger SR values are associated with better postoperative sphincter function in children with urological and anorectal malformations. Our results demonstrated that after completion of BF, the normal SR group had a significantly better improvement of some of the uroflowmetry indicators and LUTD-associated symptoms compared to the low SR group. Our findings implied that although BF therapy is an efficient treatment for children with LUTD, irrespective of their sacral development; children with enhanced sacral development may benefit from better clinical response, especially in terms of LUTD-associated symptoms.

Subungual Osteochondroma of the Great Toe: A Case Report.

Bony outgrowths of the distal phalanx of the great toe have been described in the literature but rarely. These subungual bony outgrowths can be caused by subungual exostosis or subungual osteochondromas. Both of these abnormalities are bony outgrowths with differences in the cartilage cap wherein the exostoses have fibrocartilage, and osteochondromas have hyaline cartilage. The subungual exostosis and osteochondroma that are protruding present symptoms of pain, redness, and deformed nail bed, whereas the nonprotruding osteochondromas have only a lump as the presenting symptom. In both conditions, excision of the lesion and curettage of the base helps prevent a recurrence. Curettage at the end of the excision of the bony outgrowth is required to avoid recurrence. After excision, the specimen should be sent for histopathologic examination to differentiate between the exostosis and osteochondromas, which are underreported in subungual locations, and to rule out malignant transformation. We present a 13-year-old girl with an isolated subungual nonprotruding exostosis of the great toe that was treated by excisional biopsy. The histopathologic examination confirmed it as osteochondroma, which is underreported.

Prevalence, Features, and Predictive Factors of Spontaneous Spinal Arthrodesis in Posttraumatic Thoracolumbar Kyphosis

ObjectiveSpontaneous spinal arthrodesis (SSA) is a phenomenon of spontaneous fusion, and SSA is not rare in post-traumatic thoracolumbar kyphosis (PTK). However, few reports have focused on SSA in patients with PTK. The objective of this study was to investigate the prevalence, features and predictive factors of SSA in PTK patients. MethodsIn this retrospective study, 70 patients with PTK were included. Data on the clinical and radiological parameters were obtained and evaluated. According to whether there was SSA or not, patients were divided into SSA group (n=45) or non-SSA group (n=25). A binary logistic regression analysis was used to identify the predictive factors for SSA. ResultsThe incidence of SSA in PTK was 64%. Among 45 PTK cases with SSA, SSA could be present as a solid bridging anterior osteophyte along the vertebral bodies in 11 cases, posterior contiguous bony growth through the facet joints bilaterally in 13 cases, bony formation in both anterior and posterior elements in 18 cases, and direct contiguous bony formation from injured vertebral body to adjacent one in 3 cases. Patients with longer disease duration, larger local Cobb angle and anterior wall height loss ratio (AWHL) of injured vertebral body, and less kyphosis flexibility index were significantly more likely to develop SSA. The parameter of AWHL remained significant in binary logistic regression analysis. ConclusionsSSA in PTK was common, and SSA sign could be present as various patterns, which might have implications for surgical decisions. AWHL was the independent predictor for SSA.

A rare case of solitary exostosis of capitate

Exostosis arising from carpal bones is rare and only a few cases have been reported till date. A 29 years old female came to the outpatient department with a localized swelling present on the dorsum of her right wrist since the past three years. On examining the patient clinically, a well-defined protuberance was observed over the dorsal aspect of the right wrist. CT report showed bony outgrowth over the dorsum of the capitate extending beyond the carpometacarpal joint. In surgical intervention, the mass was removed from the base, which grossly had an appearance of chondral origin. The biopsy report confirmed the diagnosis of exostosis (osteochondroma). Hence, excising the exostosis surgically led to achievement of adequate motion of the patient's wrist along with the additional cosmetic correction benefit.

Canalplasty using osteotome in a unilateral ear auditory exostoses (EAE) without cold water exposure: a case report

Background: Ear auditory exostoses (EAE) or surfer’s ear is a slow benign bony growth within the external auditory canal (EAC). The exact etiology of EAE remains unclear but it is commonly associated with chronic exposure to cold water or wind. The technique of surgery can be transcanal, endaural, or postauricular approach, based on the surgeon's experience. To our knowledge, this is the first documented report of a patient with recurrent EAE without cold water exposure. The purpose of this study is to present a rare case report about a woman with unilateral EAE without cold water exposure with transcanal osteotome surgical approach. Case presentation: A 29-years-old woman was referred to the Ear, Nose, and Throat Department, West Nusa Tenggara General Hospital, Mataram, Indonesia with left ear fullness since one week ago. The patient was told that she had a lump within the ear canal since 2013 but she had no symptoms. There was no history of recurrent ear infection or participating in water activities. Otoscopy of the left ear revealed a lump rising from EAC that covers 90% of EAC. We could not visualize the left tympanic membrane. The CT scan of her temporal bone demonstrated a hard density mass in the left EAC. The patient was done surgically with a transcanal approach. Indication for this patient was the occlusion of more than 80% of EAC. Transcanal with osteotome was chosen because of its less complication than others. Conclusion: It is unusual that our patient developed EAE without the usual precipitating factor. The surgery was done with a transcanal approach with an osteotome to prevent complications postoperative. Future experimental studies should be performed.

An Atypical Midline Anterior Torus Mandibularis: A Case Report

Benign bony growths called tori can develop in various places throughout the mandible and maxilla, although their exact origin is still unknown. There have been numerous reports of unilateral or bilateral Mandibular Tori (MT); however, no reports of a midline anterior mandibular tori have been made yet. A 27-year-old female patient reported with a complaint of a bony growth on her lower jaw below the tongue. The tori are unusually situated at the midline on the lingual side of the mandibular central incisor. The elements shown to be causal were the gender of the male, the ethnicity of Asians, and developmental in origin. The cornerstone of treatment for Tori is surgical resection. After a year of follow-up, there was no recurrence. The present case highlighted the significance of etiological factors for bony exostosis management and recurrence, which, in conjunction with origin, gender, ethnic and racial factors, may account for the patient’s lack of recurrence.

Osteochondromas Gone Pelvic: A Case Report of Concurrent Tibial Osteoblastoma and incidental detection of multiple pelvic Osteochondromas on bone scan.

In a unique clinical presentation, a 20-year-old female with a known left distal Tibial Osteoblastoma (previously treated via curettage) developed pain and weight-bearing difficulties in her left lower limb six months later. Subsequently bone scan revealed a unprecedented clinical presentation: residual activity in the treated Osteoblastoma alongside additional foci of increased tracer uptake on skeletal scintigraphy, localized to the bilateral anterior superior and inferior iliac spines. Subsequent radiographs confirmed sessile bony outgrowths in these locations, consistent with multiple pelvic Osteochondromas (an uncommon variant). Notably, these Osteochondromas lacked associated radiolucencies or cortical destruction. Further MRI confirmed the Osteochondroma diagnosis. Interestingly, the patient declined surgical intervention for the asymptomatic Osteochondromas, prioritizing ongoing treatment for the primary Osteoblastoma. This case highlights the rare co-occurrence of these distinct tumor types in an uncommon usual pelvic location, emphasizing the importance of patient centered treatment approach based on patient preferences and clinical context.

Morphometric and morphologic analysis of the foramen spinosum in the Slovenian population with clinical correlations.

The foramen spinosum (FS) is a pivotal passage for neurovascular structures within the skull base. We performed a detailed morphometric and morphological analysis of the FS to emphasize its clinical relevance. The study was performed on dried skull specimens obtained from the anatomical collections of the Institute of Anatomy and Institute of Forensic Medicine of the University of Ljubljana. The morphometric and morphologic features of FS in 126 whole human skulls and 15 skull halves were analyzed, including dimensions, shape, and other anatomical variations, as well as relationships to surrounding structures. Measurements were done with a digital sliding caliper. The mean length and width of the FS were 2.45 ± 0.65 mm and 2.03 ± 0.53 mm on the right side and 2.49 ± 0.61 mm and 2.08 ± 0.48 mm on the left side. The most frequently observed shape was round (56.7%), followed by oval (28.2%), irregular (8.7%) and drop shaped (6.3%). Several anatomical variations were also noted, including FS duplication, confluences with other foramina, and FS obstruction due to marginal bony outgrowths. The FS exhibits notable interindividual differences in anatomical characteristics which should be considered during neurosurgical procedures and radiological interventions in the skull base.

Endoscopic septoplasty below the age of 17 years

BackgroundThe claim that septoplasty in children should not be done was raised in the early last century. Pediatric septoplasty is highly controversial. Some surgeons are concerned that early surgical intervention before age 17 can adversely affect the normal growth of the nose and face. On the contrary, there is evidence of significant dental, palatal, and facial abnormalities following traumatic damage to the septal cartilage. Therefore, surgical correction of the deviated nasal septum may be performed regardless of the patient’s age. The recommendation of early surgery is based on the explanation that the earlier the correction of septal deviation, the better the outcome of developing normal breath and acceptable facial growth. This study evaluates the nasal and facial bony growth after endoscopic septoplasty for patients below the age of 17 years.MethodsThis retrospective study reviewed 39 patients who underwent endoscopic septoplasty. The involved patients’ age at surgery was below 17 years old. Postoperative evaluation was done for all patients subjectively using the visual analog scale (VAS) and objectively by endoscopic nose examination. The nasal and facial bony growth were evaluated using lateral cephalometry, which was carried out for each patient when they reached the age of 17.ResultsThirty-nine patients underwent endoscopic septoplasty. The median visual analog scale for nose block and headache significantly declined after the procedure significant differences were observed between patients and controls regarding the following parameters: palatal length, anterior skull base, mid-face protrusion, and mid-face length.ConclusionEarly endoscopic septoplasty below the age of 17 is a safe procedure and does not compromise the nasal or facial growth when indicated for patients with severe persistent nose block and poor quality of life.

Growth patterns of young achondroplasia patients in Korea and predictability of neurosurgical procedures

BackgroundAchondroplasia is an autosomal dominant disorder mainly affecting bony growth, typically resulting in markedly short stature. From a neurosurgical viewpoint, patients sometimes develop spinal cord compression at the narrowed foramen magnum and hydrocephalus. This study aims to construct growth references for height, weight, and head circumference (HC) of young achondroplasia patients in Korea and to evaluate the predictability of the necessity and timing of neurosurgical procedures through growth patterns.MethodsGrowth data were collected from achondroplasia patients who visited our institution between January 2002 and August 2022. First, we constructed percentile growth curves of height, weight, and HC for the patients under 3 years of age with the generalized additive model for location, scale, and shape (GAMLSS). Second, the growth patterns of the patients with hydrocephalus who underwent neurosurgical procedures such as foramen magnum decompression (FMD) and ventriculoperitoneal (VP) shunt were analyzed.ResultsThere were 125 achondroplasia patients, including 67 males and 58 females. Among 125 patients, 46 underwent FMD, and 5 underwent VP shunt. As short stature and macrocephaly were typical characteristics of achondroplasia, the height of achondroplasia was lower than that of the general population, and HC in achondroplasia showed accelerated growth postnatally. There were no significant changes in HC in hydrocephalus patients before they underwent neurosurgical procedures. The influence of hydrocephalus on the growth patterns of HC in achondroplasia seemed insignificant.ConclusionGrowth references for height, weight, and HC in young achondroplasia patients were constructed. It is the first report of growth patterns of achondroplasia in Korea. Unlike other pediatric patients, the diagnosis of hydrocephalus and the necessity of neurosurgical procedures are hard to be predicted with HC in achondroplasia. Neuroimaging should be considered for achondroplasia patients with neurological symptoms.