title: Spinal hemiepiphysiodesis decreases the size of vertebral growth plate hypertrophic zone and cells.
abstract: BACKGROUND
  Hemiepiphysiodesis is a potential method to treat idiopathic juvenile scoliosis early. The purpose of the present study was to investigate a mechanism of curve creation in the pig thoracic model of spinal hemiepiphysiodesis by determining whether the structure of the vertebral growth plate varied with distance from the stapled, concave side of the spine. The hypotheses were that the heights of the hypertrophic zone, hypertrophic cells, and disc would be decreased on the treated side of the treated level as compared with both an unstapled control level and the side opposite the staple.
  
  
  METHODS
  Custom spine staples were implanted into six midthoracic vertebrae in each of five skeletally immature pigs. After eight weeks, the spines were harvested and histological sections were prepared. Hypertrophic zone height, hypertrophic cell height and width, and disc height were measured at discrete coronal plane locations at stapled and unstapled thoracic levels. Differences between stapled and unstapled levels and locations were compared with use of mixed linear modeling for repeated measures, followed by regression models to determine growth plate intercept and slope across the plane by thoracic level.
  
  
  RESULTS
  Zone height, cell height, and cell width were lowest on the stapled side of the stapled level, with significant differences in the overall statistical model (p < 0.02). Disc heights were significantly reduced (p < 0.0001) at the stapled levels across the coronal plane.
  
  
  CONCLUSIONS
  Unilateral control of intervertebral joint motion decreased growth plate height, cell size, and disc height.
authors.affiliation: Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA. Donita.Bylski-Austrow@cchmc.org.
authors.forename: Donita I
authors.initials: DI
authors.lastname: Bylski-Austrow
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Wall
authors.forename: David L
authors.initials: DL
authors.lastname: Glos
authors.forename: Edgar T
authors.initials: ET
authors.lastname: Ballard
authors.forename: Andrea
authors.initials: A
authors.lastname: Montgomery
authors.forename: Alvin H
authors.initials: AH
authors.lastname: Crawford
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006132:Growth Plate / Q000473:pathology*; D006984:Hypertrophy; D007403:Intervertebral Disc / Q000473:pathology; D013123:Spinal Fusion / Q000379:methods*; D017792:Surgical Stapling; D013552:Swine; D013904:Thoracic Vertebrae / Q000473:pathology*