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ABNORMAL BILATERAL ASYMMETRY OF UPPER ARM LENGTH IN GIRLS WITH RIGHT THORACIC ADOLESCENT IDIOPATHIC SCOLIOSIS (RT-AIS) IS ASSOCIATED WITH RIGHT UPPER ARM OVERGROWTH: SENTINEL OF ABNORMAL SPINAL GROWTH? (SUPPORTED BY AO)

British Scoliosis Society (BSS) Annual Meeting



Abstract

Aim:

Right-Handed Girls With Rt-Ais Measured Using Holtain Equipment Have Upper Arm Length Asymmetry (Right-Minus-Left) Which Is: 1) Relatively Longer On Scoliosis Curve Convexity; 2) Significantly Associated With Scoliosis Curve Severity (Cobb Angle And Apical Vertebral Rotation); And 3) Transient, Decreasing With Age And Years After Menarche [1,2]. The Aim Is To Test Whether The Right Upper Arm Length Relative Overgrowth And Spinal Deformity Severity Were Associated With Right Or Left Upper Arm Length Size-For-Age.

Method:

94 Right-Handed Girls With Rt-Ais, Age 11–18 Years, (Mean Cobb Angle 46 Degrees, Range 10–102 Degrees), Were Evaluated Using A Harpenden Anthropometer For Upper Arm Length Asymmetry, Plotted Against Right And Left Upper Arm Length Standard Deviation Scores (Sds), Calculated From 378 Normal Girls, Age 11–18 Years.

Results:

The Findings Show That Upper Arm Length Asymmetry Correlates Significantly With Right, But Not Left, Upper Arm Length Sds (Right Arm Spearman's Rho=0.330 P=0.001; Left Arm Rho=−0.013 P=0.902), And With No Other Limb Or Trunk Skeletal Region Sds. Cobb Angle And Avr Also Correlate Significantly With Right, But Not Left, Upper Arm Length Sds.

Discussion:

The Abnormal Asymmetry Of Upper Arm Lengths Results From Relative Overgrowth Of Right Upper Arm. We Suggest This Asymmetry Results From An Abnormal Asymmetry Process (Eg Neurogenic) With Growth Velocity That Together Also Initiate The Trunk Deformity, Wherein Additional Factors Contribute To Scoliosis Progression Such As Upright Posture, Melatonin-Signalling Dysfunction And Osteopenia. The Right Upper Arm Length Overgrowth May Provide A Sentinel Of The Relative Anterior Spinal Overgrowth.

Conflict Of Interest Statement: No conflict of interest.