Pineal transplantation after pinealectomy in young chickens has no effect on the development of scoliosis

STUDY DESIGN: Three experimental groups and one control group of chickens underwent different surgical procedures to determine the effects of pineal gland transplantation on the development of scoliosis. OBJECTIVE: To determine whether transplantation of the pineal gland to the body wall musculature maintains serum melatonin levels at normal values and prevents the development of scoliosis. SUMMARY OF BACKGROUND DATA: Scoliosis occurs consistently after pinealectomy in young chickens. Many characteristics of this scoliosis are similar to those seen in patients with adolescent idiopathic scoliosis. It is not clear whether the underlying mechanism is dependent on reduced levels of serum melatonin or some other aspect of the extensive surgery. METHODS: Four groups of chickens were selected: normal chickens, pinealectomized chickens, chickens that underwent simple cutting of the pineal stalk, and chickens that underwent transplantation of the pineal gland into the body wall. Development of scoliosis was determined from measurement of the Cobb angle from weekly radiographs. RESULTS: All of the experimental groups showed the same levels of incidence and the same patterns of scoliosis development. Serum melatonin levels were reduced to nearly zero in all the experimental groups for the duration of the experiment. Scoliosis developed in none of the normal chickens. CONCLUSIONS: Neither transplantation of the pineal gland into the body wall musculature nor simple cutting of the pineal stalk was able to maintain normal levels of serum melatonin because both procedures reduced levels to nearly zero. The incidence and pattern of scoliosis development in these groups were the same as those for the pinealectomized group. Reduction of serum melatonin levels remains a prerequisite for scoliosis development in young chickens.     

The effects of melatonin therapy on the development of scoliosis after pinealectomy in the chicken

The mechanism underlying the development of scoliosis after pinealectomy in young chickens is unknown. However, since the main product of the pineal gland is melatonin, melatonin remains an obvious focus in studies designed to discover this mechanism. One confounding factor is that serum melatonin levels are close to zero after pinealectomy but scoliosis does not develop in all chickens that have had this procedure. Therefore, the role of melatonin in the development of scoliosis in chickens after pinealectomy remains controversial. In the current investigation, two pilot studies demonstrated that a physiological therapeutic dose of melatonin (2.5 milligrams per kilogram of body weight) restored the circadian rhythm of melatonin, as measured by serum assay. In the main study, this dose was administered daily starting either immediately after the pinealectomy or two weeks after it, when scoliosis had developed. Scoliosis was assessed on weekly radiographs, and the Cobb angle was determined for all chickens in which scoliosis developed. Overall, scoliosis developed in only 56 percent (fifty) of the eighty-nine chickens that had had a pinealectomy; this rate was consistent throughout all experimental groups. Scoliosis did not develop in any of the control chickens, which did not have a pinealectomy. On the basis of the average Cobb angles in the chickens in which scoliosis had developed, it was determined that neither the prevalence nor the pattern of the scoliosis was affected by the therapy in any of the experimental groups. It was thus concluded that melatonin therapy after pinealectomy in young chickens has no effect on the development or progression of scoliosis. These results raise doubts regarding the role of melatonin in the development of scoliosis after pinealectomy in the young chicken.     

Pathogenesis of idiopathic scoliosis. Experimental study in rats.

STUDY DESIGN: A radiographic examination of pinealectomized rats to observe the development of scoliosis and halt the condition by administration of melatonin. OBJECTIVES: To discover whether pinealectomy has the same effect in mammals as shown in the chicken, and to determine whether the bipedal condition is important for development of scoliosis. SUMMARY OF BACKGROUND DATA: Pinealectomizing chickens shortly after hatching consistently resulted in scoliosis closely resembling human idiopathic scoliosis. It has not been determined whether this phenomenon is restricted solely to chickens, or if this experimental model is applicable to other animals, especially those more closely related to humans. METHODS: A sham operation in five bipedal rats served as the control in this study. Pinealectomy was performed in 10 quadrupedal rats, pinealectomy in 20 bipedal rats, and pinealectomy with implantation of melatonin pellet in 10 bipedal rats. Spinal radiographs were used to measure the degree of scoliosis at 3 months after surgery. RESULTS: Scoliosis developed only in pinealectomized bipedal rats and not in quadrupedal rats. It developed in none of the sham operation group and in only 1 of 10 pinealectomized bipedal rats with melatonin treatment. CONCLUSIONS: Melatonin deficiency secondary to pinealectomy alone does not produce scoliosis if the quadrupedal condition is maintained. The bipedal condition, such as that in chickens or humans, plays an important role in the development of scoliosis. The findings suggest a critical influence of a postural mechanism for the development of scoliosis.     

Correlation between the age of pinealectomy and the development of scoliosis in chickens

STUDY DESIGN: Pinealectomy induces experimental scoliosis in chickens. This study analyzed the correlation between the age at which pinealectomy was performed and the development of scoliosis in chickens. OBJECTIVE: To investigate the differences in the rate or magnitude of scoliosis and the type of curvature in chickens pinealectomized at different times after hatching. SUMMARY OF BACKGROUND DATA: Scoliosis develops in almost all chickens pinealectomized within 3 days after hatching, but there are no data on whether the condition will develop in chickens pinealectomized earlier or later after hatching. METHODS: In this study, 106 female white leghorn chickens were divided into six groups: four pinealectomy groups (pinealectomy was performed 2, 4, 11, or 18 days after hatching in Groups P-2, P-4, P-11, and P-18, respectively), a control group (Group C), and a sham operation group (Group S). Ventrodorsal radiographs of the spine were taken at 4-week intervals until the age of 12 weeks. At 12 weeks, a 1-mL sample of blood was taken from the heart at the middle of the dark cycle, and the serum melatonin concentration was measured by radioimmunoassay. RESULTS: At the age of 12 weeks, scoliosis was present in 63.6% of the chickens in Group P-2, 72.7% in Group P-4, 81% in Group P-11, and 70% in Group P-18, and the Cobb angles in the scoliotic chickens averaged 32.6, 29.8, 23.8, and 22.3 degrees in the respective groups. There were no significant differences in the rate or magnitude of scoliosis and the type of curvature among the pinealectomy groups at the age of 12 weeks. At the age of 12 weeks, the serum melatonin levels at the middle of the dark cycle in the pinealectomized chickens were significantly lower than those of chickens in Groups C and S. However, there were no differences in the serum melatonin levels between scoliotic and nonscoliotic pinealectomized chickens. CONCLUSIONS: Findings from this study show that scoliosis develops in 60% to 80% of chickens pinealectomized within 18 days after hatching, and that scoliotic development is not influenced by the age at which pinealectomy is performed. However, this study suggests that melatonin plays a complicated role in spinal development, inasmuch as the serum melatonin levels after pinealectomy approximated zero. Yet scoliosis did not develop in all pinealectomized chickens.     

Pinealectomy in the chicken: a good model of scoliosis?

The phenomenon of spinal deformity in the pinealectomized chicken has led researchers to postulate a disturbance of melatonin activity as a potential cause of adolescent idiopathic scoliosis (AIS). More recently, structural differences between curves seen in this model and those seen in scoliosis have been highlighted suggesting the deformities observed are not as similar as first thought. We examined melatonin levels, and the radiological and histological characteristics of scoliosis after pinealectomy in chickens. They underwent pinealectomy (P) at 2 days of age, sham surgery (S) or served as controls (C). Mean melatonin levels were 32.9 pmol/L (P), 175 pmol/L (S) and 227.3 pmol/L (C). Scoliosis developed in 75% of chickens after pinealectomy and 38% after a sham procedure. Nineteen percent of unoperated controls also developed scoliosis. A lower melatonin level was associated with the development of scoliosis (p ≤ 0.001), but exceptions were seen with levels up to 265 pmol/L observed in one case. Most of the curves occurring spontaneously and after sham surgery and almost half after pinealectomy were short angular curves: distinct from those resembling idiopathic scoliosis. These occur over one or two segments and are characterized by marked apical wedging, frequently associated with subluxation or dislocation. The intervertebral joint in the chicken is more like a synovial joint histologically than an intervertebral disc. This study highlights important differences between the chicken and the human, and between their respective spinal deformities. Caution is advised when drawing conclusions regarding the pathogenesis of AIS from this model.     

Melatonin and adolescent idiopathic scoliosis

Scoliosis seen in the chicken after pinealectomy resembles adolescent idiopathic scoliosis in man. It has been suggested that in both species, deficiency of the pineal hormone, melatonin, is responsible for this phenomenon. In nine patients with adolescent idiopathic scoliosis and in ten age- and gender-matched controls, the circadian levels of serum melatonin and the excretion of urinary 6-hydroxy-melatonin-sulphate, the principal metabolite of melatonin, were determined. There were no statistically significant differences in the secretion of serum melatonin or the excretion of urinary 6-hydroxy-melatonin-sulphate between the patients and the control group. The hypothesis of melatonin deficiency as a causative factor in the aetiology of adolescent idiopathic scoliosis cannot be supported by our data.     

The effects of pineal gland transplantation on the production of spinal deformity and serum melatonin level following pinealectomy in the chicken

Pinealectomy frequently produces spinal deformity in some animal models, but the precise biological mechanism of this phenomenon remains obscure. The current study investigated the effects of an autograft pineal body on the development of spinal deformity and serum melatonin (MLT) concentration after pinealectomy in the chicken. Thirty-six chickens (2 days of age) were divided into three equal groups. While the removal of the pineal gland was performed in groups B and C, a pineal body autograft was surgically implanted into the body wall musculature only in the pineal transplantation group (group C). Chickens in which no surgical intervention was performed served as intact controls (group A). Posteroanterior radiographs of the spines of the chickens were taken at the age of 8 weeks. These were used to determine Cobb angles and to measure the rib-vertebra angles (RVA) on the concave and convex sides of the curves, from which data the difference between the convex and concave RVA (the RVAD) was calculated. At the end of the study, serum MLT levels were determined using the enzyme-linked immunosorbent assay method, and histopathological examination of specimens from all the groups was performed. The results were compared using one-way analysis of variance followed by Duncan's test for pairwise comparisons or by the Kruskal-Wallis test followed by the Mann-Whitney U tests for comparisons between two groups. In this study, the serum MLT levels in groups B and C were significantly lower than those in group A ( P<0.05). However, scoliosis developed in only 7 of 12 (58%) in group B and 6 of 12 (50%) in group C. The average Cobb angle and RVAD in groups B and C were significantly larger than those found in group A ( P=0.000 and P=0.001, respectively). Interestingly, there were no significant differences in either serum MLT levels or development of scoliosis between groups B and C. From the results of the current study, it is evident that the intramuscular pineal gland transplantation following pinealectomy in young Hybro Broiler chickens has no significant effect on the development of spinal deformity and serum MLT level. In the light of this result, the role of MLT in the development of spinal deformity in chickens after pinealectomy remains controversial, and further investigations are warranted.     

Pathologic mechanism of experimental scoliosis in pinealectomized chickens

STUDY DESIGN: This study was designed to investigate the pathologic mechanisms of idiopathic scoliosis using experimentally induced scoliosis in chickens. OBJECTIVE: To understand the process of producing a scoliotic deformity in pinealectomized chickens. SUMMARY OF BACKGROUND DATA: Pinealectomy in chickens consistently produces scoliosis with anatomic characteristics similar to those of human idiopathic scoliosis. Pinealectomized chickens are an important animal model for the study of idiopathic scoliosis. METHODS: In this study, 40 chickens were divided into two groups; 20 chickens treated with pinealectomy and 20 with a sham operation as control subjects on the second after hatching. The chickens in both groups then were killed at intervals ranging from 1 to 20 weeks after surgery. Their spines were examined visually and radiologically for the presence of a scoliotic curve and vertebral deformities. RESULTS: Rotational lordoscoliosis developed in pinealectomized chickens. The chickens with severe scoliosis were characterized by apically wedge-shaped vertebrae. In contrast, no scoliosis with any vertebral deformity developed in any of the chickens that received a sham operation. CONCLUSIONS: Because there normally is evidence of lordosis in the thoracic spine of chickens, the rotational instability of the spine induced by pinealectomy may produce a scoliotic deformity as a secondary phenomenon. Pinealectomy in chickens consistently produces scoliosis with anatomic characteristics similar to those of human idiopathic scoliosis. The authors believe that disturbance of the equilibrium and the posture mechanism associated with a defect in melatonin synthesis after pinealectomy may promote the development of rotational lordoscoliosis.     

褪黑素在鸡脊柱侧凸模型中的影响

目的　通过鸡松果体蒂部切断的方法 ,研究褪黑素在松果体切除鸡脊柱侧凸动物模型中的作用。方法　 10只刚孵育出的WhiteLeghorn鸡作为对照组 ,未行任何处理 ,控制白天 12h光照 (强度 5 0 0Lux)、夜间 12h完全黑暗 (强度 0 - 5lux)条件下饲养 ;2 0只WhiteLeghorn鸡在鸡龄 3d时行松果体切除 ,控制光照条件同对照组 ;2 0只WhiteLeghorn鸡 3d时行松果体蒂部切断术 ,控制光照同对照组。 5周时留取所有鸡白天 (mid -day)和夜间 (mid -night)的血清 ,用RIA试剂盒测定血清中褪黑素含量。所有的鸡处死后 ,取骨骼标本 ,行脊柱前后位平片检查。结果　 5周时 ,对照组褪黑素含量呈现明显白天低 (5 7.2 5± 7.4 3)pg/ml,夜间高 (2 5 7.92± 2 6 .0 9)pg/ml的周期性变化。松果体切除组褪黑素含量 ,白天为 (6 0 .0 5± 5 .4 8)pg/ml,夜间为 (5 5 .0 9± 8.35 )pg/ml,其分泌维持低水平。松果体蒂部切断组褪黑素含量 ,白天为 (5 8.77± 8.4 4 )pg/ml,夜间为 (2 4 8.4 7± 2 7.2 1)pg/ml,仍呈白天低 ,夜间高的周期性变化。X线检查 :对照组 10只鸡无脊柱侧凸发生 ;松果体切除组 2 0只鸡中 9只鸡发生了脊柱侧凸 ,发生率为 4 5 % ;松果体蒂部切断组 2 0只鸡中有 11只发生了侧弯 ,发生率为 5 5 %。结论　松果体切除和松果体蒂部     

Pineal gland metabolism in patients with adolescent idiopathic scoliosis

The scoliosis observed in chickens after pinealectomy resembles that seen in humans with an adolescent idiopathic scoliosis, suggesting that melatonin deficiency may be responsible. However, to date there have been no studies of pineal gland glucose metabolism in patients with adolescent idiopathic scoliosis that might support this hypothesis. We examined the excretion of urinary 6-sulfatoxyl-melatonin as well as the glucose metabolism of the pineal gland in 14 patients with an adolescent idiopathic scoliosis and compared them with those of 13 gender-matched healthy controls using F-18 fluorodeoxyglucose brain positron emission tomography. There was no significant difference in the level of urinary 6-sulfatoxyl-melatonin or pineal gland metabolism between the study and the control group. We conclude that permanent melatonin deficiency is not a causative factor in the aetiology of adolescent idiopathic scoliosis.     

Pathological mechanism of idiopathic scoliosis: experimental scoliosis in pinealectomized rats

The pathological mechanism of curve progression in idiopathic scoliosis is still obscure. In this study we investigated the pathological mechanism of idiopathic scoliosis in experimentally induced scoliosis in rats. A total 30 rats were divided into three groups: ten bipedal rats with a sham operation, which served as the control; ten quadrupedal rats with pinealectomy; and ten bipedal rats with pinealectomy. Scoliosis developed only in pinealectomized bipedal rats and not in pinealectomized quadrupedal rats. Cervicothoracic lordosis developed in bipedal rats with or without pinealectomy. These deformities of lordoscoliosis in pinealectomized bipedal rats were similar to human idiopathic scoliosis. Lordosis or lordotic tendency was sufficient to cause the spine to rotate to the side. Rotational instability of the spine with rotation of lordotic segment appears to produce a characteristic scoliotic deformity as a secondary phenomenon. Our findings suggest that lordosis may develop in bipedal rats, but pinealectomy is required for the development of lordoscoliosis. Balanced muscle tone controlled by the postural reflex is important to maintain normal posture with a straight spine in the bipedal condition. The disturbance of equilibrium and other postural mechanisms secondary to a deficiency of melatonin after pinealectomy may promote development of lordoscoliosis with vertebral rotation especially in the bipedal posture.     

Adolescent idiopathic scoliosis. Is low melatonin a cause?

BACKGROUND: Although the cause of adolescent idiopathic scoliosis remains unclear, pinealectomy is followed by the development of scoliosis in chickens. Melatonin is the only hormone secreted by pineal gland. OBJECTIVE: To assess serum melatonin levels in adolescents with idiopathic scoliosis. METHODS: Serum melatonin was assayed once, at 12:00 hours, in each of 20 adolescents with idiopathic scoliosis and 10 age-matched siblings. In the patient group, mean age was 14.3 years and the mean Cobb angle was 54.5 degrees (range, 20 degrees-110 degrees). Mean age in the control group was 14 years. RESULTS: Serum melatonin was significantly lower in the patients (mean, 7.7 pg/mL; range, 4 to 13 pg/mL) than in the controls (mean, 29.9 pg/mL; range, 19.3 to 46 pg/mL) (P < 0.00001). The 12 surgically treated patients had a mean melatonin level of 8.1 pg/mL, versus 7.2 pg/mL in the eight other patients (nonsignificant P and regression coefficient values). Serum melatonin was not significantly correlated with the Cobb's angle (regression coefficient, 0.18; P < 0.44). CONCLUSION: Our data suggest that serum melatonin levels may contribute to the pathogenesis of idiopathic scoliosis.     

Scoliose idiopathique de l'adolescence : la mélatonine est-elle en cause ?

Background. Although the cause of adolescent idiopathic scoliosis remains unclear, pinealectomy is followed by the development of scoliosis in chickens. Melatonin is the only hormone secreted by pineal gland. Objective. To assess serum melatonin levels in adolescents with idiopathic scoliosis. Methods. Serum melatonin was assayed once, at 12:00 AM, in each of 20 adolescents with idiopathic scoliosis and 10 age-matched siblings. In the patient group, mean age was 14.3 years and the mean Cobb angle was 54.5° (range 20°–110°). Mean age in the control group was 14 years. Results. Serum melatonin was significantly lower in the patients (mean, 7.7 pg/mL; range, 4 to 13 pg/mL) than in the controls (mean, 29.9 pg/mL; range, 19.3 to 46 pg/mL) (P<0.00001). The 12 surgically treated patients had a mean melatonin level of 8.1 pg/ml, versus 7.2 pg/mL in the eight other patients (nonsignificant P and regression coefficient values). Serum melatonin was not significantly correlated with the Cobb's angle (regression coefficient, 0.18; P<0.44). Conclusion. Our data suggest that serum melatonin levels may contribute to the pathogenesis of idiopathic scoliosis.     

Vertebral deformities and scoliosis

Scoliosis, especially idiopathic scoliosis, is a complex three-dimensional deformity of the spine in which the vertebral deformities are known, cuneal deformation being the most commonly known deformity but not the only one. We report here data concerning these specific vertebral deformities in chickens. A pinealectomy was performed in a controlled series of animal experiments. This technique induces progressive scoliosis in more than 80% of chickens, with the advantage of being non-aggressive to the spine. Vertebrae included in major thoracolumbar curves were observed in 17 chickens (11 male, 6 female) and classified into three types of vertebral deformities. Vertebral deformity type 1 is characterized by three-dimensional corporeal torsion, which defines the horizontal disorientation of the curve. Vertebral deformities type 2 and 3 define lateral imbalance in the election plane of the curve. Radiological and anatomical data collected throughout the progression of the scoliosis indicate that there is a correlation between structural vertebral deformities and growth/ maturation patterns. We compare our results with those reported in literature concerning human idiopathic scoliosis and experimental animal scoliosis.     

Microcomputed tomographic evaluation of vertebral microarchitecture in pinealectomized scoliosis chickens

Pinealectomy was used to induce scoliosis in Broiler chickens, and the bone microarchitecture of the concave and convex sides in pinealectomized scoliosis chickens was assessed by microcomputed tomography (micro-CT). Few studies have assessed the vertebrae bone microarchitecture of the concave and convex sides in scoliosis although the curvature of the coronal plane is the main deformity in scoliosis. The purpose of this study was to determine whether there are differences in the bone microarchitecture of the concave and convex sides in pinealectomized scoliosis chickens by the technique of micro-CT. The etiology and the pathogenesis of the idiopathic scoliosis remain unclear. Limited information is available on the microarchitecture of vertebrae bone of the concave and convex sides of scoliosis, especially in the earlier stage in scoliosis development. One hundred female Broiler chickens were divided into three groups as follows: the control group (n=20), the sham operation group (n=20), and the pinealectomy group (n=60). Then the pinealectomy group was divided into three groups according to the time of killing the chickens: 1-week after the operation (group P-1 w, n=20), 2 weeks after the operation (group P-2 w, n=20), and 3 weeks after the operation (group P-3 w, n=20), respectively. Posteroanterior radiographs of the spine were taken to detect spinal curvature. Using micro-CT, the bone volume/tissue volume (BV/TV), trabecular thickness (Tb.Th), trabecular number (Tb.N), and trabecular separation of the concave and convex sides of the apex vertebrae in the scoliotic chickens were determined. Independent t-tests were used to assess differences of bone parameter of the concave and convex sides in each pinealectomized group. The incidences of scoliosis in the pinealectomized Broiler chickens were 84.2% (group P-1 w), 88.9% (group P-2 w), and 89.5% (group P-3 w), respectively. In groups P-1 w and P-2 w, there were no differences between the concave and convex trabecular bone microarchitectures. In group 3 w, the BV/TV, Tb.Th, and Tb.N of the concave side were significantly greater than those of the convex side. In the earlier stage of pinealectomized scoliosis chickens, there are no histological evidence of a metabolic abnormality. The greater BV/TV, Tb.Th, and Tb.N of the concave side in group P-3 w may be consistent with Wolff's law and are the secondary response to the scoliotic deformity.     

Abnormalities of the lumbar spine in the coronal plane on plain abdominal radiographs

The main objective of this study is to determine the prevalence of coronal abnormalities of the lumbar spine in a large population of patients with respect to their age and sex. Lumbar degenerative disease is associated with degenerative scoliosis. Degenerative scoliosis and lateral listhesis are important features to identify before decompressive surgery as deformity may not be seen on magnetic resonance imaging scans. Scoliosis and lateral listhesis may be important in the development of symptoms especially in an ageing population. All abdominal and plain kidney–ureter–bladder radiographs performed over a 10-month period were reviewed. 2,765 radiographs were assessed for scoliosis (Cobb angle greater then 10°), lateral listhesis and evidence of osteoarthritis. The prevalence of scoliosis, lateral listhesis and osteoarthritis of the lumbar spine increased with age. Scoliosis and lateral listhesis were significantly more prevalent in women. Deformity starts to occur after the age of 50 and steadily increases with age. By the ninth decade nearly a quarter of patients have evidence of scoliosis and lateral listhesis. As the adult lumbar spine ages, the prevalence of lateral listhesis and degenerative scoliosis increases. It is important to appreciate these coronal abnormalities in patients undergoing decompressive surgery for spinal stenosis. This increase in deformity may have a greater impact as the population continues to age.     

Scoliosis in patients with diastrophic dysplasia: a new classification

STUDY DESIGN: Scoliosis in patients with diastrophic dysplasia was analyzed. OBJECTIVES: To study the natural history of scoliosis and to classify the patients with different types of scoliosis. SUMMARY OF BACKGROUND DATA: Typical findings in diastrophic dysplasia are short-limbed short stature, multiple joint contractures, early degeneration of joints, and spinal deformities. The largest studies have reported scoliosis in 37% to 88% of the patients with this rare skeletal dysplasia. The natural history of the deformity is unknown. METHODS: Of the 130 unselected patients, 98 (75%) who were older than 16 years and/or had undergone surgery at the time of the last radiograph were included in the final analysis. These 98 patients included 37 males and 61 females. Their ages at the first radiograph ranged from newborn to 78 years (average, 21 years). The mean follow-up period was 20 years (range, 2-41 years) for 80 patients. Standard standing anteroposterior and lateral radiographs were taken. The degrees of scoliosis, kyphosis, and lordosis were measured according to the Cobb method. Classification of the scoliosis was based on the patient's age at onset of scoliosis, the rate of progression, the magnitude of the scoliosis at the end of growth, and the curve pattern. RESULTS: Of the 98 patients in this study, 86 (88%) had scoliosis. This difference was highly significant statistically (P < 0.001), as compared with the normal population. The frequency of scoliosis was 90% among females and 84% among males. Scoliosis can be divided further into three subtypes: early progressive (11 patients), idiopathic-like (41 patients), and mild nonprogressive (33 patients). One patient had a congenital scoliosis. CONCLUSIONS: Scoliosis is very common in patients with diastrophic dysplasia. The natural history of scoliosis varies from severe deformity with rapid progression to mild deformity without any progression. The authors suggest that the classification described in this report offers a tool for the predicting natural history of scoliosis in diastrophic dysplasia, and for adjusting the timing of surgery in individual patients.     

The effect of pinealectomy and foetal pineal transplantation on collagen ageing in rats

Summary Recent progress in pineal research emphasized the importance of this circumventricular organ in the phenomenon of ageing as well. The present study was undertaken to elucidate the effects of pineal gland on collagen ageing by spectrofluorometrically measuring collagen-cross-link bound fluorescein. Experiments were performed on three different age groups of rats (3–4 weeks, 8–10 weeks, 15 and more weeks). Fluorescein values were found to increase causally by age in the control group. Eight weeks after sham operation of all the groups fluorescein level increments were shown to be parallel with the values of normal physiological ageing values. In experimental groups; in 3–5 weeks old rats pinealectomy produced a significant premature collagen ageing and this was found to be completely reversed by foetal pineal gland transplantation, but the reversal was limited to a sham operation level. On the other hand although a premature collagen ageing was found to be induced 8 weeks after pinealectomy in 8–10 weeks old rats with a statistical significance both within subject values and between sham operation and pinealectomy, foetal pineal gland transplantation was found not to reverse the premature ageing induced by pinealectomy. In 15 weeks old and older groups of rats, pinealectomy was found to facilitate the intrinsic ageing phenomenon of collagen with statistical significance again both within subject values and between sham operation and pinealectomy. Foetal pineal gland transplantation was not performed in this age group of rats. On interpretation of the data of pinealectomy against sham operation for all the age groups, the maximum degree of percentage increase in collagen-cross-link bound fluorescein was found in 3–5 weeks old rats (%218). The percentage increase in fluorescein values was found to be %170 and %126 in 8–10 weeks old and 15 weeks old and older rat groups, respectively. Consequently, we have experimentally shown the induction of collagen ageing by pinealectomy and the restorative competence of foetal pineal gland transplantation in the present study. The results seem to be impressive and details of the ageing process are the subject of further research.     

Progressive scoliosis in cri-du-chat syndrome over a 20-year follow-up period: a case report

STUDY DESIGN: A long-term follow-up study of a patient who had scoliosis associated with cri-du-chat syndrome was performed. OBJECTIVE: To describe for the first time the characteristics and natural course of progressive scoliosis in a patient with cri-du-chat syndrome. SUMMARY OF BACKGROUND DATA: Scoliosis is a common condition in patients with cri-du-chat syndrome. However, there are no reports on the clinical characteristics and course of this spinal deformity. METHODS: The current condition and radiographs of a 33-year-old man with cri-du-chat syndrome were assessed. The records and serial radiographs of his spine were reviewed retrospectively over a 29-year period, between ages 4 and 33 years. RESULTS: The scoliosis had started before the initial radiographic examination and progressed rapidly during the growth period. After this stage, slow but continuous progression was observed over the next 10 years. The final curvature was quite substantial, measuring 119 degrees. CONCLUSIONS: To determine the most appropriate treatment for the scoliosis associated with cri-du-chat syndrome, the characteristics and natural course of the scoliosis should be clarified. Although this first report on this type of scoliosis is informative, more cases and further studies are needed.     

Scoliosis induced by anterior and posterior rhizotomy

This paper presents the result and statistical analysis of an experiment in which selective anterior or posterior rhizotomy was carried out under microscopic surgery. The animals used for the experiment were 48 young rabbits, and they were divided into four groups. Group 1, which was used as control, was subjected to lower dorsal bilateral laminectomies with dural incision; Group II to laminectomies with three right posterior rhizotomies; Group III to laminectomies with three right anterior rhizotomies, and Group IV to laminectomies with three right anterior and posterior rhizotomies. Scoliosis was induced in Groups II, III, and IV. There was no significant statistical difference in the degree of curvatures among these three groups. The convexity of the curvature faced to the side of the divided roots. In Groups III and IV, scoliotic curvatures were obvious within 2 weeks, but there were no considerable changes thereafter. In Group II, the curves progressed slowly up to the 12th week. They were statistically significant at the fourth week and increased continuously thereafter. The histologic findings in Groups III and IV showed denervation atrophy of the paravertebral muscles at the apex of the curvature, but there was little or no muscle atrophy in Groups I and II. The experimental results indicate that scoliosis may be induced not only by anterior root paralysis but also by selective posterior root paralysis.