Three-dimensional analysis of formation failure in congenital scoliosis.
METHODS
Morphologic analysis was performed by 3-dimensional (3D) CT in 75 patients with congenital scoliosis exhibiting formation failure.


OBJECTIVE
The objectives of this study were to conduct 3D analysis of the morphology of spinal malformation and to elucidate the association between malformed vertebrae and adjacent vertebrae.


BACKGROUND
The morphology of spinal malformation has conventionally been evaluated by plain radiograph radiography. Although the usefulness of 3D CT has recently been reported, these reports have only demonstrated that this technique allows more detailed evaluation than plain radiography.


METHODS
We examined the morphology of the posterior components in spinal malformation of formation failure and evaluated the association between the anterior and posterior components by 3D CT. We clarified the morphologic variations of the posterior components in spinal malformation by dividing 75 cases of formation failure into solitary and multiple numbers of malformed vertebrae and into simple and complex modes of malformation between anterior and posterior components.


RESULTS
Thirty-three patients exhibited a single malformed vertebra in the entire spine (solitary malformation group), while the other 42 had multiple malformed vertebrae (total, 102 malformed vertebrae: multiple malformation group). The multiple malformation group consisted of 26 patients (57 malformed vertebrae) in whom the cause of scoliosis could be explained separately for each of the malformed vertebrae and 16 patients (45 malformed vertebrae) in whom the structure was complicated and the cause of scoliosis could not be explained for each of the malformed vertebra.


CONCLUSIONS
There were morphologic variations of the posterior components of malformed vertebrae. A completely new complex malformation in which the mechanism of formation failure may differ from the conventionally proposed mechanisms was also found.
Nakajima
Akira
A
Department of Orthopedics, Tokai Central Hospital, Japan.
Kawakami
Noriaki
N
Imagama
Shiro
S
Tsuji
Taichi
T
Goto
Manabu
M
Ohara
Tetsuya
T
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted; D012600:Scoliosis / Q000151:congenital* / Q000000981:diagnostic imaging*; D012720:Severity of Illness Index; D013131:Spine / Q000002:abnormalities / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*