Idiopathic scoliosis and the vestibular system

Abstract

Purpose Despite its high prevalence, the etiology underlying idiopathic scoliosis remains unclear. Although initial scrutiny has focused on genetic, biochemical, biomechanical, nutritional and congenital causes, there is growing evidence that aberrations in the vestibular system may play a role in the etiology of scoliosis. In this article, we discuss putative mechanisms for adolescent idiopathic scoliosis and review the current evidence supporting a role for the vestibular system in adolescent idiopathic scoliosis. Methods A comprehensive search of the English literature was performed using PubMed (http://www.ncbi.nlm.nih.gov/pubmed). Research articles studying interactions between adolescent idiopathic scoliosis and the vestibular system were selected and evaluated for inclusion in a literature review. Results Eighteen manuscripts of level 3-4 clinical evidence to support an association between AIS and dysfunction of the vestibular system. These studies include data from physiologic and morphologic studies in humans. Clinical data are supported by animal model studies to suggest a causative link between the vestibular system and AIS. Conclusions Clinical data and a limited number of animal model studies suggest a causative role of the vestibular system in AIS, although this association has not been reproduced in all studies.

Evaluation of motion sickness susceptibility by motion sickness susceptibility questionnaire in adolescents with idiopathic scoliosis: a case–control study

“…The difficulty of managing sensory conflict can be explained by failure of the central nervous system to integrate multisensory information from vestibular, somesthesic and visual modalities [6,9,24]. This failure to integrate multisensory information may generate orthostatic postural control disorder with an impact on the trunk, especially an asymmetrical tone of paraspinal muscles, which, in growth period, may cause scoliotic deformation [2,6].…”

“…One of AIS etiological hypotheses is that the scoliotic deformation is the result of orthostatic postural control disorder, with a disturbance of internal representation of the gravitational vertical [6]. Thus, the vestibular system is the most studied sensory modality [6,[9][10][11], because it has an important role in orthostatic postural control, and measures the earth gravitational vector directly. An asymmetric disturbance of the vestibular system leads to an asymmetric activity of vestibular-spinal tract, and an asymmetric paravertebral muscle tone, which, in growing adolescent results in a scoliotic deformity [10].…”

“…This abnormality could induce, via impaired activity of vestibulo-spinal tract, asymmetric paravertebral muscle tone [9,11]. This asymmetric recruitment of paraspinous musculature, in growth period, leads to scoliotic deformation [9,11]. The second theory is supported by other authors [12,13].…”

“…In favor of the first theory, investigations in AIS have shown disturbances of the different sensory modalities [5][6][7][8][9]. For example, several authors suggest asymmetrical peripheral disorder of the vestibular system in AIS [6,[9][10][11]. This abnormality could induce, via impaired activity of vestibulo-spinal tract, asymmetric paravertebral muscle tone [9,11].…”

“…For example, several authors suggest asymmetrical peripheral disorder of the vestibular system in AIS [6,[9][10][11]. This abnormality could induce, via impaired activity of vestibulo-spinal tract, asymmetric paravertebral muscle tone [9,11]. This asymmetric recruitment of paraspinous musculature, in growth period, leads to scoliotic deformation [9,11].…”