Study Of The Vertebral Morphology And Radiographic Manifestations In Children With Scoliosis

Objective: The aim of this study is to get to know the morphological characteristics ofnormal spine and study the morphology and imaging findings about vertebral of childrenwith scoliosis. It can not only provide basic references for children with scoliosis in surgery,also reduce surgical complications and improve long-term effects of the disease.Methods:1. Observation in the morphological thoracolumbar vertebrasOne bone specimen was selected from the human dry bone collections of ZunyiMedical College, Department of Anatomy. We could divide them into three groups,respectively:Ⅰgroup (including T1~T6), Ⅱ group (including T7~T12) and Ⅲ group(including L1~L5). Respectively, pedicle of the middle lateral diameters, coronal andsagittal angles from T1to L5were measured with physical measurement of devices andobserved the exact position of the base into the vertebrae.2. Observation in radiographic presentationThe observed group (Group A): It could be from Pediatric Surgery at Children’sHospital of Guiyang in June,2012to March,2014. All of children with scoliosis weretreated and there were15cases in total, including8males and7females; age ranged from1year to14years (mean8.9years);8cases of semi-vertebral deformities and7cases ofidiopathic scoliosis.The control group (group B):10cases of the spine imaging data in children withnon-spinal disease could be from Guiyang Children’s Hospital Radiology. All of childrenhave been underwent X-ray (including the full length of the spine and the iliac crest), CTand MRI. After all, we could observe their thoraces, vertebras, spinal cords and so on. Wemight be capable of measuring6vertebral pedicles of the middle lateral diameters, coronaland sagittal angles.3. Intraoperative observations We have observed the morphological changes in vertebralpedicles, vertebral bodies and the adjacent vertebral laminas.Results:1. Observation in the morphological thoracolumbar vertebras 1.1The lateral diameter was6.67±1.08in group one. Group two was8.05±3.34. Groupthree was14.46±4.92. No statistically significant difference in groupⅠwith group Ⅱ(6.67±1.08vs8.05±3.34, P＞0.05). There is statistically significant difference in groupⅠwith group Ⅲ and in group Ⅱ with group Ⅲ (6.67±1.08vs14.46±4.92, P<0.05;8.05±3.34vs14.46±4.92, P<0.05).1.2The coronal pedicle angle was24.25±6.90in group one. Group two was19.83±4.08.Group three was26.30±7.22. No statistically significant difference in groupⅠwith groupⅡ and in groupⅠwith group Ⅲ (24.25±6.90vs19.83±4.08, P＞0.05;24.25±6.90vs26.30±7.22, P＞0.05). There is statistically significant difference in groupⅡ with group Ⅲ(19.83±4.08vs26.30±7.22, P<0.05). The thoracic vertebral pedicle sagittal plane anglewas22.33±3.80in group one. Group two was21.75±2.66. Group three was7.00±1.12. Nostatistically significant difference in groupⅠwith group Ⅱ(22.33±3.80vs21.75±2.66, P＞0.05). There is statistically significant difference in groupⅠwith group Ⅲ and in groupⅡwith group Ⅲ (22.33±3.80vs7.00±1.12, P<0.05;21.75±2.66vs7.00±1.12, P<0.05).1.3The base of thoracic vertebral pedicle accounted for a quarter at the height of vertebrae,while the lumbar vertebral arch accounted for a half.2. Radiographic observationThe adjacent vertebral pedicle transverse diameter of the six concave side of spineswas5.54±0.88in group A (observation group). And also the six sudden side of spine was7.21±1.11in group A. There is statistically significant difference of the adjacent vertebralpedicle transverse diameter of the six concave side of spines in group A(5.54±0.88vs7.21±1.11, P<0.05). The adjacent vertebral concave and sudden side of pedicle axis and themidline sagittal angle was27.85±4.19and32.68±3.96in group A, respectively. Whereas,corresponding to group A, which consisted of pedicle axis and the midline sagittal anglewas29.86±2.38in group B. There is statistically significant difference of the adjacentvertebral concave and sudden side of pedicle axis and the midline sagittal angle in group Awith group B(27.85±4.19vs29.86±2.38, P<0.05;32.68±3.96vs29.86±2.38).3. Intraoperative observationThe sudden lateral pedicles in scoliosis patients have been became thick and hard.However, we observed that concave side of the pedicles had been relatively become slim inintraoperation. There have been vertebral body fusion and semi-vertebral deformities in scoliosis vertebras, what’s more, concave side of the vertebral body have been became flat,the other side has been relatively became thick. Lateral lamina and intervertebrae havebeen different levels of changes, such as rotation, width, narrowness and so on.Conclusions:1. The differences between the lateral diameters of the upper thoracic pedicle and under thelower thoracic pedicle were not evident, but the lateral diameters of the thoracic pediclewere thicker than the lumbar pedicle. The upper thoracic vertebral coronal line with theaxis of the pedicle angle was smaller than the angle of the lumbar. The thoracic vertebralpedicle axis and the midline sagittal angle was a little larger than the lower thoracic, but theangle of the lumbar was minimum among them. The base of thoracic vertebral pedicleaccounted for the thickness of the sagittal plane between the turn of a quarter and threequarters, while the base of lumbar vertebral arch accounted for half.2. Scoliosis pedicles have been become thin and the height sudden pedicle is higher thanthat of the concave side. These changes have been not only the adjacent vertebrae in thesudden or the concave side, also have neighboring vertebral body and lamina.3. Pedicle screw fixation was popularly used for clinical treatment of scoliosis. We shouldpay attention to the morphologies, radiographic characteristics and directions in process ofpedicle screw placement in preoperation or intraoperation.