Current biomechanical theories on the etiopathogenesis of idiopathic scoliosis

Spine Deformity - Trang 1-9 - 2023
Javier Pizones1, Dong-Gune Chang2, Se-Il Suk2, Enrique Izquierdo3
1Department of Orthopedic Surgery, Spine Unit, Hospital Universitario La Paz, Madrid, Spain
2Department of Orthopedic Surgery, College of Medicine, Inje University Sanggye Paik Hospital, Inje University, Seoul, Korea
3Spine Unit, Hospital Universitario de Getafe, Madrid, Spain

Tóm tắt

There is great controversy about the etiologic origin of adolescent idiopathic scoliosis. Multiple theories have been suggested, including metabolic aspects, endocrine dysfunction, neurological central abnormalities, genetic predisposition and epigenetic factors involved in the development of scoliosis. However, there has always been speculations based on human biomechanical behavior. In this article, we performed a literature review on the biomechanical traits of human posture, and the proposed theories that explain the special characteristics present in idiopathic scoliosis. The current theory on the etiopathogeneis of AIS suggests that dorsally directed shear loads acting on a preexisting axial plane rotation, in a posteriorly inclined sagittal plane of a growing patient, together with disc maturation, collagen quality at this phase of development and immaturity of proprioception, is the perfect scenario to spark rotational instability and create the three-dimensional deformity that defines idiopathic scoliosis. The unique spinal alignment of human bipedalism, gravity and muscle forces acting straight above the pelvis to preserve an upright balance, and the instability of the soft tissue in a period of growth development, is an appealing cocktail to try to explain the genesis of this condition in humans.

Tài liệu tham khảo

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