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Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 443 - 443
1 Aug 2008
Chaloupka R Parmova J Kapralova M Svobodnik A Krbec M Repko M
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Genetic factors and impairment of central nervous system (CNS) are known factors in aetiology of adolescent idiopathic scoliosis. MRI pathology of CNS (brain asymmetry, syringomyelia) was found. Perinatal pathology could cause damage of CNS.

Material and method: Perinatal risk factors are evaluated in adolescent idiopathic scoliosis – AIS group (39 patients) compared with normal individuals – N (28 persons).

In the AIS group, the mean onset of right thoracic curve was 12,2 years, apex vertebrae were T7 – T11 (T8 in 8 cases, T8–9 in 5, T9 in 12 cases), mean Cobb angle measured 49,0 degrees (SD 14,500), thoracic kyphosis T3-T12 19,9 (SD 12,167), lumbar lordosis T12-S1 –53,1 (SD 8,338).

A questionnaire was created to identify parental age, diseases, mother diseases and remedies during pregnancy, pregnancy duration, child resuscitation, childbirth pathology, incubator, jaundice duration, diseases during the first year of life, beginning of sitting and standing, right or left handing. Results have been processed by software Statistica 7.1. StatSoft, Inc. (2005). For evaluation of potential difference between AIS and N groups two-sample t-test for continuous parameters was used. Two-sample t-test and Fisher test were testing the hypothesis that the values of parameters make no difference between two groups (on the 0,05 significant level).

Results: More children who required an incubator were found in AIS group – 4, N group – 1 (statistically insignificant). We found these statistically significant differences:

- Occurrence of familiar scoliosis in AIS group – nine out of 39, 0 in N group.

- Child diseases during the first year of life in N group –18 out of 28 in N, 10 out of 39 AIS.

- Early sitting in AIS group (6,5 months), 7,6 in N.

- More males in N group (15 out of 28), 8 out of 39 in AIS.

Conclusion: These finding confirm the importance of genetic factors and support the influence of CNS dysbalance factors in early childhood. The earlier sitting (in AIS group) could start the dysbalance of postural motor system. Further studies are necessary.


Orthopaedic Proceedings
Vol. 90-B, Issue SUPP_III | Pages 434 - 434
1 Aug 2008
Chaloupka R Dvorak M Necas A Vesely J Svobodnik A Krbec M Repko M
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The aetiology of idiopathic scoliosis, despite of long-lasting efforts to disclose it, remains unknown.

The purpose of the study was to evaluate the spine development after pinealectomy or cortical sensory motor area damage in the growing rats.

Method: The authors operated 69 Wistar albino rats (aged three to four weeks) in antraperitoneal anaesthesia. In the first group (22 rats) pinealectomy – PIN was performed, in the second one (25) the sensory motor cortical area 2x1x1 mm bellow the coronal suture was removed – SMCA. The sham operation consisted of craniotomy – CRA (11 rats) and craniotomy with durotomy – CRDU (11 rats). All surgeries were performed from the left side. Radiography was made three months after surgery. Scoliosis, C2-T7 lordosis, T7-S1 kyphosis were measured. Results have been processed by software Statistica 7.1. StatSoft, Inc. (2005). We used ANOVA test for evaluation of potential difference between groups, in the case of approving the difference between groups, we tested difference between each two groups by two-sample t-test. Those tests were realised on 0,05 significant level.

Results: In the PIN group scoliosis 9–14 degrees (mean value 10,8) developed in five animals, in SMCA group scoliosis 10 – 24 degrees (mean value 15,9) was observed in eight animals.

These statistically significant differences were found: higher surgery weight in PIN, longer surgery time in PIN and SMCA, lower lordosis in PIN and higher in CRDU, differences of all groups in kyphosis and in an end weight.

Conclusion: Our results indicate the importance of cortical area damage, together with craniotomy and durotomy in the development of growing rat spine. We cannot exclude the influence of peri-operative bleeding, brain hypoxia or metabolic effect of anaesthetics.

These damages could cause a disorder of balance between smaller inhibitory and greater facilitating area of CNS, controlling the muscular tone and resulting in the development of lordosis and scoliosis due to muscle imbalance.