A team led by Donita Bylski-Austrow, PhD, director of the Biomechanics Research Laboratory at Cincinnati Children’s, has spent more than a decade investigating the growth plate structure of skeletally immature scoliosis patients in order to learn more about scoliosis curve progression. In FY16, the team began to analyze and quantify the results. This understanding is crucial to translate growth modification techniques for scoliosis patients from preclinical to clinical use. The purpose of Bylski-Austrow’s study was to determine human vertebral physeal hypertrophic zone and cell size in subjects with and without spine deformity. Her team compared vertebral growth plates’ hypertrophic zone and cell heights from patients with severe scoliosis with both human controls and quadrupedal models.

Bylski-Austrow presented the following findings that were identified in FY16:

• Growth plate samples were removed from the curve apex of skeletally immature patients (five with adolescent idiopathic scoliosis and three with congenital scoliosis in this study).
• Control sections were identified from pathology autopsy files to include the same age range without spine deformity.
• Samples were taken from locations at or near the apex on the convex curve side of the spine.
• Hypertrophic zone and cell heights on the convex side were 20-25 percent lower in scoliosis patients than in controls.
• These reductions were similar in both direction and magnitude to changes caused by experimental growth modulation and by applied compression.

Hypertrophic zone heights and cell heights for humans (control and scoliosis), and comparisons with previously published in vivo porcine models (control and stapled), and an in vivo rat tail model (control and compressed). Vertebral growth plate structures were lower due to scoliosis in humans.

Bylski-Austrow concluded these results may support theories of curve progression and translational models of spine growth modulation, and may contribute to a deeper understanding of how to treat these disorders in the future by altering growth plate structure in strategic locations, thereby fine-tuning abnormal growth rather than fusing the spine. She and her team plan to publish their complete study findings in the fall of 2017.