title: Clinical anatomy of vertebrae in scoliosis: global analysis in four different diseases by multiplanar reconstructive computed tomography.
abstract: BACKGROUND
  Few accurate analyses of clinically useful vertebral anatomy have been conducted, and most have focused on thoracic idiopathic scoliosis.
  
  
  OBJECTIVE
  To evaluate the different anatomic characteristics in scoliosis by disease type and level.
  
  
  METHODS
  Observational cohort study.
  
  
  METHODS
  Forty-eight patients with scoliosis were included in this study.
  
  
  METHODS
  Subjects underwent computed tomography (CT) of the whole spine.
  
  
  METHODS
  Forty-eight patients with scoliosis were included in this study: 15 adolescent idiopathic, 11 cerebral palsy (CP), 10 muscular dystrophy (MD), and 12 congenital (CG) scoliosis patients with similar demographics. Subjects underwent CT of the whole spine, preoperatively. Eight anatomic parameters were measured in multiplanar reconstructive CT images, and statistical analysis was performed to investigate differences.
  
  
  RESULTS
  In general, values in the anatomic parameters were similar for the four diseases. Each parameter showed the unique change pattern according to the spinal level regardless of curvature shape, direction, or magnitude. In particular, chord length (CL) in MD and CG scoliosis was lower than in adolescent idiopathic scoliosis (AIS) and CP, and pedicle rib unit length was lower in CG scoliosis than in the other diseases (p<.05). Comparisons of convex and concave anatomies in AIS showed that inner pedicle width (PWI) and outer pedicle width (PWO) were wider for convex side, CL, pedicle width, and transverse pedicle angle were greater for concave side (p<.05), and differences were more significant at apices. However, in CP, PWI and PWO were similar between convex and concaves sides (p>.05). Although PWI and PWO were wider for convex sides and CL and pedicle length were greater for concave sides in MD (p<.05), differences were less significant at apices. Particularly, CG scoliosis showed severely deformed anatomy, with differences of seven parameters at apical vertebrae (p<.05).
  
  
  CONCLUSIONS
  Clinical anatomies of vertebrae in scoliosis were found to differ significantly at different levels and in terms of convexity and disease type.
authors.affiliation: Department of Orthopedics, Korea University Ansan Hospital, Gojan Dong, Danwon Gu, Ansan 425-707, Republic of Korea. Electronic address: osspine@korea.ac.kr.
authors.forename: Jae-Young
authors.initials: JY
authors.lastname: Hong
authors.forename: Seung-Woo
authors.initials: SW
authors.lastname: Suh
authors.forename: T R
authors.initials: TR
authors.lastname: Easwar
authors.forename: Suk Joo
authors.initials: SJ
authors.lastname: Hong
authors.forename: Yong-Chul
authors.initials: YC
authors.lastname: Yoon
authors.forename: Hyung-Jin
authors.initials: HJ
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D002547:Cerebral Palsy / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D009136:Muscular Dystrophies / Q000000981:diagnostic imaging; D012600:Scoliosis / Q000000981:diagnostic imaging*; D013131:Spine / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Multiplanar reconstruction; Scoliosis; Vertebral morphology