Mechanical modulation of vertebral body growth - Implications for scoliosis progression

Study Design. The authors developed a rat-tail model to investigate the hypothesis that vertebral wedging during growth in progressive spinal deformities results from asymmetric loading in a ''vicious cycle.'' Objectives. To document growth curves with axial compression or distraction applied to tail vertebrae to determine whether compression load slows growth and distraction accelerates it. Summary of Background Data. Progression of skeletal deformity during growth is believed to be governed by the Hueter-Volkmann law, but there is conflicting evidence to support this idea. Methods. Twenty-eight 6-week-old Sprague-Dawley rats were assigned to one of three group: compression loading, distraction loading, or sham (apparatus applied without loading). Under general anesthesia, two 0.7-mm diameter stainless steel percutaneous pins were used to transfix each of two vertebrae. The pins were glued to 25-mm diameter external ring fixators. Springs (load rate, 35 g/mm) were installed on three stainless steel threaded rods that were passed through holes in each ring and compressed with nuts to apply compression or distraction forces between 25-75% of bodyweight, Vertebral growth rates in mu m/day were measured by digitizing the length of the vertebrae images in radiographs taken 0, 1, 3, 5, 7, and 9 weeks Results. The loaded vertebrae grew at 68% of control rate for compressed vertebrae and at 114% for distracted vertebrae. (Differences statistically significant, P < 0.07 by analysis of variance.) For the compressed vertebrae, the pinned vertebrae, which were loaded at one of their two growth cartilages, grew at a reduced rate (85%), although this effect was not apparent for the distraction animals. Conclusions. The findings confirm that vertebral growth is modulated by loading, according to the Hueter-Volkmann principle. The quantification of this relationship will permit more rational design of conservative treatment of spinal deformity during the adolescent growth spurt.