Impact of the Vestibular System on the Formation and Progression to Idiopathic Scoliosis: A Review of Literature

Abstract

The physiopathogenesis of adolescent idiopathic scoliosis remains unknown. However, a multifactorial pathogenesis is being assumed. Besides biomechanical, biochemical, and genetic factors, some studies have focused on congenital or acquired abnormalities in the vestibular organ with consecutive development of scoliosis. This study aims to analyze a possible correlation between any vestibular organ congenital or acquired pathologies and scoliosis based on the current literature. Therefore, we conducted a literature search in three databases, with search terms such as “scoliosis,” “organ of balance,” “idiopathic scoliosis,” “vestibular organ,” “spine,” and “balance.” Fifteen studies were selected and used for research. The relationship between scoliosis and vestibular organ abnormalities was recorded from all included works. Seven studies demonstrated a direct correlation between vestibular organ anatomical abnormalities and the form of the scoliotic spine. Another study confirmed the influence of the pathology of the vestibular organ on scoliosis but questioned whether it had an impact on the formation or the progression of the curvature. Others demonstrated a temporal overlap of the embryonic development of the vestibular organ and the beginning of pre-scoliotic characteristics, but their relationship remained questionable. In three studies, the correlation remained unclear, and any context has been denied. It seems unlikely that an isolated vestibular disorder can trigger structural scoliosis. However, the vestibular system pathologies may certainly occur in the multifactorial genesis of idiopathic scoliosis. Whether the correlation refers to the expression or the progression of scoliosis or may even have an influence on both remains unclear. New treatment options could be derived from these findings with a positive influence on the course of the deformity.

Prevalence of idiopathic scoliosis in athletes: a systematic review and meta-analysis

“… 48 A relationship between vestibular system abnormalities and IS has also been reported. 49 These data suggest that patients with IS experience changes in system complexity.…”

“…Proprioceptive deficits were reported in AIS patients in a recent review and meta-analysis article by Lau et al 48 A relationship between vestibular system abnormalities and IS has also been reported. 49 These data suggest that patients with IS experience changes in system complexity.…”

Biomechanical changes in adolescent idiopathic scoliosis during walking: A protocol for systematic review and meta-analysis

“…[ 52 ] Patients with AIS frequently exhibit kinematic abnormalities during walking, which can be attributed to the influence of vision, vestibular sensation, and somato proprioception. [ 53 ] A recent study discovered a correlation between the severity of scoliosis and a decrease in stride length among AIS patients. [ 54 ] In this study, subgroup analyses were conducted on selected spatiotemporal characteristic indices.…”

Vestibular Influence on Vertebrate Skeletal Symmetry and Body Shape

“…This view is supported by the early functional implementation of otolithic circuits, as shown in fish and amphibian larvae, and their impact on deformable skeletal elements during early ontogeny (Horn et al, 1986;Lambert et al, 2009Lambert et al, , 2013. Indeed, scoliotic deformations in humans are often accompanied by vestibular deficits (Manzoni and Miele, 2002;Hawasli et al, 2015;Scheyerer et al, 2020), demonstrated, e.g., by otolith endorgan-related impairments of cervical vestibular-evoked myogenic potentials in scoliotic patients (Pollak et al, 2013). A causal link between a unilateral vestibular loss and skeletal asymmetry has been confirmed in Xenopus laevis (Lambert et al, 2009).…”