Scientific Articles   |    
Disturbance of Rib Cage Development Causes Progressive Thoracic ScoliosisThe Creation of a Nonsurgical Structural Scoliosis Model in Mice
Kensuke Kubota, MD, PhD1; Toshio Doi, MD, PhD2; Masaharu Murata, PhD1; Kazu Kobayakawa, MD1; Yoshihiro Matsumoto, MD, PhD1; Katsumi Harimaya, MD, PhD1; Keiichiro Shiba, MD, PhD3; Makoto Hashizume, MD, PhD1; Yukihide Iwamoto, MD, PhD1; Seiji Okada, MD, PhD1
1 Departments of Orthopaedic Surgery (K. Kubota, K. Kobayakawa, Y.M., K.H., Y.I.) and Advanced Medical Initiatives (M.M., M.H., S.O.), Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582. E-mail address fro K. Kubota: kkubot8@ortho.med.kyushu-u.ac.jp. E-mail address for M. Murata: m-murata@dem.med.kyushu-u.ac.jp. E-mail address for K. Kobyakawa: 0809kazu@ortho.med.kyushu-u.ac.jp. E-mail address for Y. Matsumoto: ymatsu@ortho.med.kyushu-u.ac.jp. E-mail address for K. Harimaya: harimaya@ortho.med.kyushu-u.ac.jp. E-mail address for M. Hashizume: mhashi@med.kyushu-u.ac.jp. E-mail address for Y. Iwamoto: yiwamoto@ortho.med.kyushu-u.ac.jp
2 Department of Orthopaedic Surgery, Kyushu University Beppu Hospital, 4546 Tsurumihara, Tsurumi, Beppu, Oita 874-0838, Japan. E-mail: toshidoi@ortho.med.kyushu-u.ac.jp
3 Department of Orthopaedic Surgery, Japan Labour Health and Welfare Organization Spinal Injuries Center, 550-4 Igisu, Iizuka, Fukuoka 820-0053, Japan. E-mail address: keishiba@orange.ocn.ne.jp
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

K. Kubota and T. Doi contributed equally to this work.

Investigation performed at the Departments of Orthopaedic Surgery and Advanced Medical Initiatives, Graduate School of Medical Sciences, Kyushu University, and the Department of Orthopaedic Surgery, Spinal Injuries Center, Fukuoka, Japan

Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2013 Sep 18;95(18):e130 1-7. doi: 10.2106/JBJS.L.01381
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case



The pathomechanism underlying idiopathic scoliosis remains unclear, and, to our knowledge, a consistent and relevant animal model has not been established previously. The goal of this study was to examine whether a disturbance of rib cage development is a causative factor for scoliosis and to establish a nonsurgical mouse model of progressive scoliosis.


To examine the relationship between rib cage development and the pathogenesis of progressive scoliosis, a plastic restraint limiting anteroposterior rib cage development was placed on the chest of four-week-old mice. All mice were evaluated with whole-spine radiographs, and the severity of scoliosis was consecutively measured. The rib cage rotation angle and the anteroposterior chest dimension were measured with use of micro-computed tomography scanning. To examine whether the imbalanced load transmission through the ribs to the vertebral body was involved in our model, we performed a rib-neck osteotomy in a subgroup of the mice.


The thoracic restraint did not provoke spinal curvature immediately after it was applied, but nine of ten mice that wore the restraint but did not have rib osteotomy gradually developed progressive scoliosis. Radiographs and computed tomography images showed a right thoracic curvature, vertebral rotation, and narrow chest in the mice that had worn the restraint for eleven weeks but did not have rib osteotomy even after the restraint was removed. The anteroposterior chest dimension was significantly correlated with both the curve magnitude and the rib cage rotation angle. The progression of spinal deformity was observed only during the adolescent growth spurt, and it plateaued thereafter. The left-side rib osteotomy led to the development of progressive left-thoracic curvature, whereas the bilateral rib osteotomy did not cause scoliosis, even with restraint wear.


We established a nonsurgical experimental model of progressive scoliosis and also demonstrated that a rib cage deformity with an imbalanced load to the vertebral body resulted in progressive structural scoliosis.

Figures in this Article


    mice ; scoliosis ; rib cage ; spine
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    W. Virginia - Charleston Area Medical Center
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    District of Columbia (DC) - Children's National Medical Center
    New York - Icahn School of Medicine at Mount Sinai