Aetiological process of idiopathic scoliosis: from a normal growing spine into a complex 3D spinal deformity

In more than a century of dedicated research into its aetio-pathogenesis, many attempts have been made to understand the exact cause idiopathic scoliosis. literature, number causal theories is overwhelming and aetiology adolescent scoliosis (AIS) regarded as ‘multi-factorial’. This overview focusses on recent studies that describe changes from normal spinal anatomy complex three-dimensional deformation support hypothesis several paediatric deformities are consequence unique way human spine biomechanically loaded. has nothing do with bipedalism, but gravity muscle tone translate sagittal shape spine, pelvic lumbar lordosis, possibility simultaneously extend hips knees. leads three rather two forces acting continuously axial, anterior posterior shear. An excess shear can result in spondylolisthesis an axial loading osteochondrotic lesions. Unique for forces, these decreased rotational stiffness involved vertebral segments. Certain profiles, especially girls around pubertal growth spurt, predispose development deformity, Once growing decompensates scoliosis, it will follow right-sided pattern already present non-scoliotic spine. The ultimately rotatory lordosis apices curvatures major impact lung function quality life.