The Role of Melatonin in the Pathogenesis of Adolescent Idiopathic Scoliosis

Hilibrand, Alan S.; Blakemore, Laurel C.; Loder, Randall T.; Greenfield, Mary Lou V. H.; Farley, Frances A.; Hensinger, Robert N.; Hariharan, M.

doi:10.1097/00007632-199605150-00004

Cited by 66 publications

(43 citation statements)

References 26 publications

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“…However, none of the early experimental evidence for this [15,16] has been independently reproduced [1,3,8,9]. Constant light treatment (which suppresses melatonin secretion) has not resulted in scoliosis in chickens [5], and so it remains unclear whether melatonin levels have a role in the pathogenesis of the deformity or not.…”

Section: Introductionmentioning

confidence: 99%

Pinealectomy in the chicken: a good model of scoliosis?

2009

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The phenomenon of spinal deformity in the pinealectomized chicken has led researchers to postulate a disturbance of melatonin activity as a potential cause of adolescent idiopathic scoliosis (AIS). More recently, structural differences between curves seen in this model and those seen in scoliosis have been highlighted suggesting the deformities observed are not as similar as first thought. We examined melatonin levels, and the radiological and histological characteristics of scoliosis after pinealectomy in chickens. They underwent pinealectomy (P) at 2 days of age, sham surgery (S) or served as controls (C). Mean melatonin levels were 32.9 pmol/L (P), 175 pmol/L (S) and 227.3 pmol/L (C). Scoliosis developed in 75% of chickens after pinealectomy and 38% after a sham procedure. Nineteen percent of unoperated controls also developed scoliosis. A lower melatonin level was associated with the development of scoliosis (p B 0.001), but exceptions were seen with levels up to 265 pmol/L observed in one case. Most of the curves occurring spontaneously and after sham surgery and almost half after pinealectomy were short angular curves: distinct from those resembling idiopathic scoliosis. These occur over one or two segments and are characterized by marked apical wedging, frequently associated with subluxation or dislocation. The intervertebral joint in the chicken is more like a synovial joint histologically than an intervertebral disc. This study highlights important differences between the chicken and the human, and between their respective spinal deformities. Caution is advised when drawing conclusions regarding the pathogenesis of AIS from this model.

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Section: Introductionmentioning

confidence: 99%

Pinealectomy in the chicken: a good model of scoliosis?

2009

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“…Human adolescents 54,55 and juveniles 56 with progressive idiopathic scoliosis were reported to have reduced night-time serum levels of melatonin, although these findings have not been confirmed. [57][58][59] Methods for identifying melatonin secretion varied between studies and included night-time and daytime serum levels as well as 24-hour urinary excretion measurements. Because the ages of scoliotic subjects varied between reports, melatonin levels could influence pre-menarchal scoliotic development rather than in adolescence.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Scoliosis and Pineal Lesions in Australian Children

Day

McPhee

Tuffley

et al. 2007

J Orthop Surg (Hong Kong)

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Purpose. To determine whether treatment of pineal lesions in children is associated with development of idiopathic scoliosis. Methods. 38 boys and 10 girls with pineal lesions were identified. Their mean age at presentation was 10 years. The pineal pathology varied from cysts and epidermoid to teratoma, germinoma, pineocytoma, and glioblastoma. Treatment ranged from biopsy/ extirpation to radiotherapy. Results. 12 patients died. No scoliosis was found in any females or any of the deceased. Two boys had scoliosis: one had a 12-degree right upper thoracic curve with 32-degree kyphosis and the other had a 60-degree right thoracolumbar idiopathic curve, requiring a 2-stage arthrodesis. Conclusion. Pineal ablation is not related to the development of idiopathic scoliosis in humans.

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“…Melatonin may play a role in the pathogenesis of scoliosis (neuroendocrine hypothesis) but at present, the data available cannot clearly show the role of melatonin in producing scoliosis in humans [22,[23][24][25][26][27][28][29][30]. The biological relevance of melatonin in IS is controversial because: (a) No significant decrease in circulating melatonin level has been observed in a majority of studies, (b) experimental pinealectomy did not lead systematically to a scoliosis in all pinealectomized chickens, and (c) melatonin injections in pinealectomized animals did not always prevent the formation of scoliosis.…”

Section: The Role Of Melatonin In the Pathogenesis Of Ismentioning

confidence: 99%