The Biomechanics of Induction in Adolescent Idiopathic Scoliosis: Theoretical Factors

Sarwark, John F.; Castelein, René M.; Maqsood, Ayesha; Cé, Aubin

doi:10.2106/jbjs.18.00846

Cited by 30 publications

(16 citation statements)

References 24 publications

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“…Adolescent idiopathic scoliosis (AIS) manifests as a three-dimensional (3D) deformity of the spinal column that occurs around puberty. Several factors such as genetics 1,2 , biomechanics 3 , morphology of the vertebral bones, intervertebral disc, and muscle physiology 4–9 , hormones 10,11 , environmental factors 12,13 , and neural system deficiencies 14,15 are considered as the underlying cause of the spinal deformity in AIS. While each of these factors explained part of the pathogenesis of this disease, none have proved to be its main or primary cause.…”

Section: Introductionmentioning

confidence: 99%

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3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

Pasha

2019

Sci Rep

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Adolescent idiopathic scoliosis (AIS) is a three-dimensional (3D) deformity of the spinal column in pediatric population. The primary cause of scoliosis remains unknown. The lack of such understanding has hampered development of effective preventive methods for management of this disease. A long-held assumption in pathogenesis of AIS is that the upright spine in human plays an important role in induction of scoliosis. Here, the variations in the sagittal curve of the scoliotic and non-scoliotic pediatric spines were used to study whether specific sagittal curves, under physiological loadings, are prone to 3D deformation leading to scoliosis. To this end, finite element models of the S shaped elastic rods, which their curves were derived from the radiographs of 129 sagittal spinal curves of adolescents with and without scoliosis, were generated. Using the mechanics of deformation in elastic rods, this study showed that the 3D deformation patterns of the two-dimensional S shaped slender elastic rods mimics the 3D patterns of the spinal deformity in AIS patients with the same S shaped sagittal spinal curve. On the other hand, the rods representing the non-scoliotic sagittal spinal curves, under the same mechanical loading, did not twist thus did not lead to a 3D deformation. This study provided strong evidence that the shape of the sagittal profile in individuals can be a leading cause of the 3D spinal deformity as is observed in the AIS population.

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Section: Introductionmentioning

confidence: 99%

“…The unique shape of the human spine has been hypothesized to relate to the induction of scoliosis 3 . The dorsal loading of the upright spine in human was proposed to result in spinal instability and has been suggested as the biomechanical causation of scoliosis 22 .…”

Section: Introductionmentioning

confidence: 99%

3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

Pasha

2019

Sci Rep

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“…There is a lack of studies on the relationship between asymmetric foot biomechanics and spinal curvatures. Yet, Bialek et al (2015) and Lehnert-Schroth (2007) both advocated examination and exercising of the foot in the management of AIS patients [31,32]. Lee et al (2018) evaluated 52 juvenile patients with a mean age of 79.5 months with excessive foot pronation and mild idiopathic scoliosis [16].…”

Section: Asymmetric Foot Biomechanicsmentioning

confidence: 99%

Intervention versus Observation in Mild Idiopathic Scoliosis in Skeletally Immature Patients

Ng¹,

Ng²,

Cheng³

et al. 2020

TOORTHJ

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Introduction: Observation is the treatment of choice for idiopathic scoliosis with Cobb angles between 15 degrees - 20 degrees in growing children. This passive approach does not address the anxiety of the patient and the stress of the parents. In this paper, we attempt to identify skeletally immature patients with mild scoliosis curvatures that are more at risk of progression and propose possible intervention for this group of subjects. Methods: The literature was searched in Pubmed, and additional references were searched manually in the literature. Results: Many studies have shown that low serum 25[OH]D level, bone mineral density (BMD), and body mass index (BMI) are related to the curve severity or progression of the curve. We suggest that skeletally immature patients (< Risser 2) with mild curves be divided into two groups, viz. Group O (observation) with a lower risk of progression, and Group I (intervention) with a higher risk of curvature progression. We propose early intervention for the latter group. It is suggested that pre-menarcheal, skeletally immature patients with mild idiopathic scoliosis, and low vitamin D, BMD, and BMI should be treated. Also, asymmetric foot biomechanics should be addressed, although nutrition and foot orthoses are regarded to have no role in the management of idiopathic scoliosis. The outcome of early intervention may be utterly different from late treatment when the curvature becomes more structural, and the patient more skeletally mature. Conclusion: Research is required to prove if the intervention is clinically indicated.

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“…Adolescent idiopathic scoliosis (AIS) is a 3-dimensional spinal deformity with Cobb angle ≥10° [ 1 ]. As a common pediatric musculoskeletal disorder, it begins in early puberty and affects 1–4% of adolescents [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, great attention is paid to restricting the curve progression before an individual with AIS reaches adulthood. However, there is still an incomplete understanding of the initiation and progression of AIS [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

et al. 2020

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The Biomechanics of Induction in Adolescent Idiopathic Scoliosis: Theoretical Factors

Cited by 30 publications

References 24 publications

3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

3D Deformation Patterns of S Shaped Elastic Rods as a Pathogenesis Model for Spinal Deformity in Adolescent Idiopathic Scoliosis

Intervention versus Observation in Mild Idiopathic Scoliosis in Skeletally Immature Patients

Fiber Type-Specific Morphological and Cellular Changes of Paraspinal Muscles in Patients with Severe Adolescent Idiopathic Scoliosis

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