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Journal of Bone and Joint Surgery - British Volume, Vol 90-B, Issue SUPP_III, 433.  
Copyright © 2008 by British Editorial Society of Bone and Joint Surgery
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11th Philip Zorab Symposium

Oxford, England: 3–5 April 2006

Chairman: Mr Michael Edgar

ADOLESCENT IDIOPATHIC SCOLIOSIS (AIS) AND BASICRANIUM ASYMMETRY

D. Rousié1; O. Joly1; J. Vasseur2; P. Salvetti2; J.P. Deroubaix3; and A. Berthoz1

1 Laboratoire de Physiologie de la Perception et de l’action, Collège de France, Paris2 Clinique le Lambersart Lille.3 Service ORL, Centre hospitalier Bethune.

Introduction: Several authors observed links between AIS and asymmetries as in function and anatomy, especially in the brain. Others described high frequency of AIS in patients suffering from craniofacial asymmetry (CFA). CFA involves asymmetry of Basicranium separating the face from the brain. Because of neurodevelopmental factors, CFA reflects brain growth. So, Posterior Basicranium (PB) asymmetry involves cerebellum asymmetry and spatial asymmetry of vestibular organs. In a previous study we highlighted that CFA was associated with functional anomalies: difficulty of fixation caused by ocular torsion, off balance caused by vestibular dysfunction, postural disorders.

Purpose: To explore AIS on different levels: PB, Eyes and Vestibular System.

Patients:

  • Control group (CG):32 subjects, 26W. & 6M., fr. 8 to 51.
  • AIS group (AISG):93 subjects, 77W. & 16M., fr. 6 to 63. AIS were classified according to
    • – Amplitude of spine deformation (d°) G1: 8 to10°, G2: 10 to 15°, G3:15 to 40°
    • – Location of deformation (Ponsetti class.): TL=thoracolumbar, T=thoracic, L=lumbar.

Methods: We used MRI (EXCITE G.E.) 1.5T, head coil, Volumic T2-weighted sequence.

  • Step1: 3D Basicranium measurements in both groups with Brainvisa processing: (http://brainvisa.info/)
  • Step2: 3D anatomical study of semicircular canals in both groups with original modelling software.

Discussion: Normal subjects revealed weak asymmetry and dorsoventral rotation of P.B & cerebellum

AIS showed a pathognomic increase of these Human traits. Inside AIS subgroups, TL & G3 revealed highest levels of asymmetry and rotation.

We will discuss, thanks to AIS homozygosis twins in mirror, genetic origins for these specific P.B. & Cerebellum asymmetries.

Modelling of semi-circular canals revealed significative malformations in AIS compared to normal group. Again, T.L. and G3 revealed highest scores of canals anomalies. We highlighted a specific malformation in AIS: abnormal connexion between lateral & posterior canal.

We will demonstrate, thanks to same AIS twins, genetic origins of this malformation and propose a genetic hypothesis to link the different results.

Conclusion: These specific anomalies could be considered as preventive factors of AIS. Work supported by Cotrel Fondation.

Correspondence should be addressed to Jeremy C T Fairbank at The Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX7 7LD, UK






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General