How ‘Idiopathic’ Is Adolescent Idiopathic Scoliosis? A Systematic Review on Associated Abnormalities

Abstract

BackgroundDespite more than a century of dedicated research, the etiology and pathogenesis of adolescent idiopathic scoliosis (AIS) remain unclear. By definition, ‘idiopathic’ implies an unknown cause. Nevertheless, many abnormalities concomitant to AIS have been described, often with the suggestion that these abnormalities are related to etio-pathogenesis. Insight in the concomitant abnormalities may assist in improving the understanding of the etiological pathways of AIS. We aimed to systematically review and synthesize available studies on abnormalities concomitant to AIS.MethodsOriginal studies comparing untreated AIS patients with healthy adolescents on abnormalities other than the deformity of the spine were retrieved from PubMed and Embase. We followed PRISMA guidelines and to quantify the relationship between each abnormality and AIS we used a best-evidence-syntheses for relating risk-of-bias to consistency of effect sizes.ResultsWe identified 88 relevant citations, forty-seven carried high risk-of-bias and twenty studies did not report quantitative data in a sufficient manner. The remaining twenty-one publications failed to report data from before initiation of the deformity and blind assessments. These cross-sectional studies provided data on fourteen abnormalities concomitant to AIS. With our best-evidence-syntheses we were unable to find both strong evidence and a consistent pattern of occurrence for AIS and any of these abnormalities. From moderate risk-of-bias studies a relatively consistent pattern of occurrence for AIS and impaired gait control (4 studies; 155 subjects; Cohen’s d = 1.00) and decreased bone mineral density (2 studies; 954 subjects; Cohen’s d = −0.83) was found. For nine abnormalities a consistent pattern of occurrence with AIS was found, but the evidence for these was weak.ConclusionsBased on the available literature, strong evidence is lacking for a consistent pattern of occurrence of AIS and any abnormality. The relevance for understanding the multifactorial etiology of AIS is very limited.

Schroth Physiotherapeutic Scoliosis-Specific Exercises Added to the Standard of Care Lead to Better Cobb Angle Outcomes in Adolescents with Idiopathic Scoliosis – an Assessor and Statistician Blinded Randomized Controlled Trial

“…Adolescent idiopathic scoliosis (AIS), a three-dimensional torsional deformity of the spine and trunk[1], is the most common (84%-89%) form of scoliosis[2] with a prevalence between 0.47 and 5.2% in the general adolescent population. [3] There is a high predominance of AIS among girls, rising with higher severity of the curve.…”

The Etiologic Relevance of 3-D Pathoanatomy of Adolescent Idiopathic Scoliosis

“…Despite many years of dedicated research into the etiopathogenesis of idiopathic scoliosis, there is no single, distinct cause for this condition, and a number of intriguing questions remain. 2,3 The purpose of this study is to provide, based on our ongoing research into the etiopathogenesis of idiopathic scoliosis, answers to some of these questions, namely: 1. Why is scoliosis a disease of man?…”

Vloga reber pri nastanku in napredovanju idiopatske skolioze

“…Adolescentna idiopatska skolioza prizadene 1-4 % mladostnikov (5). Zdravniki, ki obravnavajo bolnike z adolescentno idiopatsko skoliozo, so pogosto presenečeni nad popolnoma normalnim razvojem bolnika, tako intelektualnim kot telesnim, vse do trenutka, ko se začne hrbtenica kriviti (6). Če želimo razložiti vzroke za nastanek in napredovanje skolioze, moramo odgovoriti na nekaj vprašanj: 1.…”