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.