| The neurocentral synchondrosis (NCS) is a cartilaginous growth plate locatedbetween the neural arch and the centrum of the vertebrae. It is considered importantin the growth of both the vertebral body and the posterior arch. This growth plate isbipolar and therefore contributes to the growth of both the vertebral body and theposterior arch. Since the early1900s, it has been hypothesized that unilateral closureor asymmetrical growth of the NCS could lead to vertebral rotation, alteredbiomechanics in the vertebral column, and the subsequent development of anabnormal spinal curve. Many scholars have replicated that NCS has significantcorrelation with idiopathic scoliosis（IS）through clinical observation and animalexperiment. IS is regarded as “multifactorial” in origin, but its pathogenesis remainsobscure. In elucidating the potential role of the NCS in adolescent idiopathic scoliosis(AIS), previous studies have concentrated primarily on the age of closure. Numerousmethods have been used to determine the age, including gross anatomic or histologicvisualization, radiography, CT and MRI. The function and developmental stage of theNCS are controversial because of a lack of agreement on the exact age of closure. Todate, most authors believe that the NCS is actively open at a very early age, but thereported age of closure was still various. It can be hypothesized that NCS growth gradually declines over a long period of time. For normal spinal development,symmetric growth of the NCS should occur during the most active stages of thisphysis, while also functioning during the long closure period. Currently, there is apoor understanding of the NCS in normal spine without spinal deformity. There arestill questions on the growth rate of the NCS, whether symmetric growth of the NCSoccurs in normal spine, and the timing of closure of the NCS in various locations ofthe spine. The precise contribution of NCS to vertebral development is still unclear.ObjectiveThe aim of this study was to use imaging examination, anatomic methodand histologcal method to survey the morphological characteristics of NCS in thespine of fetus and young children. So we could deduce the function of NCS in thegrowth of veterbra and vertebral pedicle in normal spine and explore the correlationbetween neurocentral synchondrosis (NCS) and idiopathic scoliosis (IS). In order toprovide reliable evidence for the diagnosis and treatment of idiopathic scoliosis (IS),especially for adolescent type.MethodsCollected18samples that without congenital spinal deformity who admitted in thethird affiliated hospital of Zhengzhou University from Oct2012to Dec2013, whichcontained15fetuses (23w-33w) and3newborn infants (1m-6m). There were8males and7females in fetus group, whose average gestational age was28+6weeksold. There were2boys and1girl in infant group with an average age of4months.The above cases have signed informed consent forms firstly. The15cases of fetuseswere separated into two group by fetal age, which had7samles (24w) less than28wand8samples with the average gestational age of33w. All spines were visualized byusing magnetic resonance imaging (MRI) techniques of T1vertebra to L5vertebra ofspine, and full spine spiral CT+three-dimensional reconstruction. Then chose twosamples from both groups to make gross spine anatomic and NCS hematoxylin-eosin(HE) staining separately. The above methods could observe the morphology of NCSin three dimensional structure. Then measuring the relevant parameters by dicomimage processing software, which including the angle of NCS with vertebra (α), thelength and width of NCS, anteroposterior vertebrae diameter in every vertebra. There were five types of perameters that contained eight groups of data. Calculating themean value of every group and constructing line by Origin software. All perametersin two sides of the NCS were analysed by means of paired t-test, and set the teststandard P=0.05. The parameters between the two groups were detected by means ofsample t-test with the standard of P=0.05. Correlation between length and width ratioof NCS and anteroposterior vertebrae diameter were analysed by using Pearsoncorrelation analysis, marked statistically, P=0.05as the test standard.Results1. NCS is made by two parallel lines that perpendicular to the vertebrae in thesagittal plane of full spine spiral CT+three-dimensional reconstruction images in twosides, and it is a V-shaped structure in the transverse plane. The MRI image showedtwo low density lines in the newborn NCS place, and presenting V-shaped structurethat pointed to the canal with the inner wide and the outer narrow. Gross anatomyshow that the two parts are combined togther in the front and separated from eachother in the behind of the vertebrae. The NCS is tapered and surrounding both thevertebral body and the posterior arch. HE staining shows the same V-shaped structureas MRI.2.1Collect and calculate the mean parameters of the two groups, and make linechats of each set. The chats show that α angle was increasing firstly and decreasingfrom T9vertebra to lumbar. The rate of change of the first group is faster than thesecond one.The others parameters of the second fetus group were bigger than the firstone.2.2The mean α angle of the left and right side of the first group were60.827°±2.794°,60.882°±2.840°respectively, and the corresponding mean angleswere58.878°±4.194°and58.749°±4.334°. The length-width ratio of the first group ofthe two sides were1.452±0.096,1.435±0.124, and the corresponding ratio were1.680±0.147,1.678±0.142. The anteroposterior vertebrae diameter in every vertebraof the two groups were1.887±0.153and1.723±0.230respectively. The parameters ofthe two groups by using paired t-test respectively drew a conclusion that thedifference of the two sides of the two group were significant (p<0.05). No statisticaldifferences were noted in the left and right side of the same group (p＞0.05). 2.3Pearson correlation analysis was used in detecting length and width ratio ofNCS and anteroposterior vertebrae diameter, it is found that rL1=-0.131(p>0.05)，rR2=-0.245,(p>0.05), rL1=0.432(p>0.05)， rR=-0.419(p>0.05). No statisticallysignificant differences were noted in each compared group.ConclusionThe neurocentral synchondrosis (NCS) is a three-dimensional growth cartilage inthe vertebra located bilaterally at the junction of the pedicle and the vertebral body,which has symmetric growth on the left and right side. It is considered that the NCSgrowth is declining gradually over a long period of time with its position changing bycertain rule symmetrically. The NCS is considered important in the growth of both thevertebral body and the posterior arch, but it can’t decide the growth of them. It maynormal spine alignment without deformity. The NCS symmetric growth may beimportant to maintain the normal spine alignment. |
PDF Full Text Request