Abnormal Spread of Junctional Acetylcholine Receptor of Paravertebral Muscles in Scoliosis Associated with Syringomyelia

Study Design: All the patients were divided into three groups and the results of AchR staining were compared.

Patient Sample: 25 patients with scoliosis associated with syringomyelia, 16 adolescents with idiopathic scoliosis, and 10 cases without scoliosis were enrolled

Outcome Measures: Acetylcholinesterase staining defined the limits of the NMJs, and AChR staining that appeared outside of these limits indicated an abnormal distribution of AchR, which meant the patient was judged positive.

Methods: All the enrolled patients were divided into three groups: SS(scoliosis associated with syringomyelia) group consisted of 25 patients with scoliosis associated with syringomyelia, AIS(adolescent idiopathic scoliosis) group included 16 adolescents with idiopathic scoliosis, and NS(non-scoliosis) group was 10 cases without scoliosis. Histological evaluation of paraspinal muscles used a double-stain immunofluorescence technique for AchR and acetylcholinesterase. Wherein acetylcholinesterase staining defined the limits of the NMJs, and AChR staining that appeared outside of these limits indicated an abnormal distribution of AchR, which meant the patient was judged positive.

Results: Histological analysis showed that none of the patients both in AIS group and in NS group was judged positive, but 14 of 25 patients in SS group scored positive for the presence of AchR outside of the NMJs. The positive rate was 44% on the convex side of the curve,and 28% on the convex side.

Conclusions: The denervation of paraspinal muscles is present in some patients with scoliosis associated with syringomyelia, suggesting that scoliosis be caused by the strength imbalance of paraspinal muscles in these patients.