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PATTERNS OF EXTRA-SPINAL LEFT-RIGHT SKELETAL ASYMMETRIES IN ADOLESCENT GIRLS WITH LOWER SPINE SCOLIOSIS: II. RELATIVE LENGTHENING OF RIGHT LOWER LIMB SEGMENTS UNRELATED TO THE LOWER SPINAL SCOLIOSIS

¹ The Centre for Spinal Studies and Surgery, Queen’s Medical Centre, Nottingham, UK , ² Department of Human Anatomy & Cell Biology & Royal Liverpool Children’s Hospital, University of Liverpool, UK , ³ Department of Orthopaedic Surgery, King’s Mill Hospital, Mansfield, UK (Supported by AO).

In subjects with lumbar, thoracolumbar or pelvic tilt scoliosis no pattern of structural leg length inequality has been reported [1]. Forty-seven girls of 108 consecutive adolescent patients referred from routine scoliosis school screening during 1996–1999 had lower spinal scoliosis – lumbar (LS) 17, or thoracolumbar (TLS) 30 (mean Cobb angle 16 degrees, range 4–38 degrees, mean age 14.8 years, left curves 25). The controls were 280 normal girls (11–18 years, mean age 13.4 years). Anthropometric measurements were made of total leg lengths (LL), tibiae (TL) and feet (FL) by one observer (RGB) and asymmetries calculated for LL, TL and FL, as absolutes and percentage asymmetries of right/left lengths. There are no detectable changes of absolute asymmetries with age for LL, TL or FL in scoliotic or normal girls. Asymmetries are found in scoliotic girls compared with normals with relative lengthening on the right for each of LL (0.95%) and TL (0.99%) (each p<0.001), but not FL (0.38%).

Conclusion: The relative lengthenings in the right leg are unrelated statistically to the severity or side of the lower spinal scoliosis; the cause is unknown and may be related to posture – free standing on the right leg [2] – to neuromuscular mechanisms, or to primary skeletal changes in growth plates of femur(s) and tibia(e).

Correspondence should be addressed to Jeremy C T Fairbank at The Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX7 7LD, UK