title: Unique local bone tissue characteristics in iliac crest bone biopsy from adolescent idiopathic scoliosis with severe spinal deformity.
abstract: Adolescent idiopathic scoliosis is a complex disease with unclear etiopathogenesis. Systemic and persistent low bone mineral density is an independent prognostic factor for curve progression. The fundamental question of how bone quality is affected in AIS remains controversy because there is lack of site-matched control for detailed analysis on bone-related parameters. In this case-control study, trabecular bone biopsies from iliac crest were collected intra-operatively from 28 severe AIS patients and 10 matched controls with similar skeletal and sexual maturity, anthropometry and femoral neck BMD Z-score to control confounding effects. In addition to static histomorphometry, micro-computed tomography (μCT) and real time-PCR (qPCR) analyses, individual trabecula segmentation (ITS)-based analysis, finite element analysis (FEA), energy dispersive X-ray spectroscopy (EDX) were conducted to provide advanced analysis of structural, mechanical and mineralization features. μCT and histomorphometry showed consistently reduced trabecular number and connectivity. ITS revealed predominant change in trabecular rods, and EDX confirmed less mineralization. The structural and mineralization abnormality led to slight reduction in apparent modulus, which could be attributed to differential down-regulation of Runx2, and up-regulation of Spp1 and TRAP. In conclusion, this is the first comprehensive study providing direct evidence of undefined unique pathological changes at different bone hierarchical levels in AIS.
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Huanxiong
authors.initials: H
authors.lastname: Chen
authors.affiliation: Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, USA.
authors.forename: Y Eric
authors.initials: YE
authors.lastname: Yu
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Jiajun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Ka-Yee
authors.initials: KY
authors.lastname: Cheuk
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Bobby K W
authors.initials: BK
authors.lastname: Ng
authors.affiliation: Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Spine Surgery, Nanjing Drum Tower Hospital, Nanjing University, Nanjing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Qiu
authors.affiliation: Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, USA.
authors.forename: X Edward
authors.initials: XE
authors.lastname: Guo
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Jack C Y
authors.initials: JC
authors.lastname: Cheng
authors.affiliation: SH Ho Scoliosis Research Laboratory, Department of Orthopaedics and Traumatology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.|Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China.
authors.forename: Wayne Y W
authors.initials: WY
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D001706:Biopsy; D001842:Bone and Bones / Q000473:pathology*; D002113:Calcification, Physiologic; D016022:Case-Control Studies; D002648:Child; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007085:Ilium / Q000473:pathology*; D008297:Male; D010012:Osteogenesis; D012600:Scoliosis / Q000473:pathology*; D013116:Spinal Cord / Q000473:pathology*