The Journal of Bone and Joint Surgery, Vol 63, Issue 2 175-182, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Juvenile kyphosis: histological and histochemical studies
E Ippolito and IV Ponseti
Histological and histochemical studies of the spine of a sixteen-year-old
boy with juvenile kyphosis who was killed in an automobile accident showed
abnormal cartilage in extensive areas of the vertebral and growth plates of
the involved vertebrae. In these areas the cartilage matrix was loose,
strongly positive when stained with alcian blue and weakly positive to
periodic acid-Schiff, and it contained numerous chondrocytes. Some
chondrocytes were irregularly shaped and others were in clusters. Vertebral
bone growth was stunted under the areas of abnormal vertebral and growth
plates. The ossification in the ring apophyses was irregular in areas of
abnormal cartilage plate, but necrotic bone was not seen. Schmorl nodes had
formed where areas of abnormal cartilage plate adjoining the nucleus
pulposus had collapsed, allowing the disc material to herniate into the
vertebral body. Clinical Relevance: The defective vertebral-bone formation
in juvenile kyphosis appears to result from abnormal vertebral and
growth-plate cartilage. The kyphosis and presumably also the cartilage
abnormality can be improved during the florid stage of the disease by
decreasing the postural load on the anterior part of the vertebrae with the
use of a proper brace.