Idiopathic Scoliosis as a Rotatory Decompensation of the Spine.

Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research
René M CasteleinJean Dubousset

Abstract

Many years of dedicated research into the etiology of idiopathic scoliosis have not led to one unified theory. We propose that scoliosis is a mechanical, rotatory decompensation of the human spine that starts in the transverse, or horizontal, plane. The human spine is prone to this type of decompensation because of its unique and individually different, fully upright sagittal shape with some preexistent transverse plane rotation. Spinal stability depends on the integrity of a delicate system of stabilizers, in which intervertebral disc stiffness is crucial. There are two phases in life when important changes occur in the precarious balance between spinal loading and the disc's stabilizing properties: (i) during puberty, when loads and moment arms increase rapidly, while the disc's "anchor," the ring apophysis, matures from purely cartilaginous to mineralized to ultimately fused to the vertebral body, and (ii) in older age, when the torsional stiffness of the spinal segments decreases, due to disc degeneration and subsequent laxity of the fibers of the annulus fibrosus. During these crucial periods, transverse plane vertebral rotation can increase during a relatively brief window in time, either as adolescent idiopathic or degen...Continue Reading

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Citations

Apr 1, 2021·Scientific Reports·Steven de ReuverRené M Castelein
Jul 23, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Steven de ReuverRené M Castelein
Aug 8, 2021·Journal of Clinical Medicine·Lorenzo CostaRené M Castelein

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