Elucidating the inherent features of IS to better understand idiopathic scoliosis etiology and progression

John F. Sarwark*, Rene M. Castelein, Tsz Ping Lam, Carl E. Aubin, Ayesha Maqsood, Florina Moldovan, Jack Cheng

*Corresponding author for this work

Research output: Contribution to journalComment/debatepeer-review

Abstract

Idiopathic Scoliosis (IS) is a relatively common condition and is estimated to affect as many as 3 % of youth aged 10–17 years (in the United States an estimated approximately 1.4 million otherwise healthy individuals). A clear understanding of the etiology will better direct optimization of evaluation, treatments and therapies, especially early treatments with less invasive methods. A mechanistic explanation of factors combining to initiate and then cause progression of this common condition– in otherwise healthy pre-teenage and teenage patients–will be discussed. A recent well-designed structured systematic review states that ‘strong evidence is lacking for a consistent pattern of occurrence and any abnormality’, in other words there is no strong evidence for ‘other associated diagnoses’ in IS. And so, certain important inherent factors of IS merit greater discussion. Inherent, or intrinsic factors include: a natural susceptibility to develop a lateral and rotational deformity in the immature rapidly growing erect human spine, inherent torsion associated at the induction of deformity, biomechanics related to curve progression, and anthropology/bipedal gait. We know more today about factors related to the condition and its etiology than we have previously. Across multiple disciplines, a mechanistic approach to understanding the etiopathogenesis of IS, allows a reasonable ‘theory’ for IS etiology and its progression. We will discuss these inherent intrinsic factors in order to further add to our understanding of the theoretical etiopathogenesis. A better understanding of the etiology (and progression) may better direct ways to optimize evaluation, treatments and therapies, especially early treatments with less invasive methods.

Original languageEnglish (US)
Pages (from-to)126-129
Number of pages4
JournalJournal of Orthopaedics
Volume26
DOIs
StatePublished - Jul 1 2021

Keywords

  • Adolescent idiopathic scoliosis
  • Biomechanics
  • Bone health
  • Etiology
  • Inherent
  • Progression

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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