Scoliosis convexity and organ anatomy are related

Abstract

Purpose Primary ciliary dyskinesia (PCD) is a respiratory syndrome in which 'random' organ orientation can occur; with approximately 46% of patients developing situs inversus totalis at organogenesis. The aim of this study was to explore the relationship between organ anatomy and curve convexity by studying the prevalence and convexity of idiopathic scoliosis in PCD patients with and without situs inversus.Methods Chest radiographs of PCD patients were systematically screened for existence of significant lateral spinal deviation using the Cobb angle. Positive values represented right-sided convexity. Curve convexity and Cobb angles were compared between PCD patients with situs inversus and normal anatomy. Results A total of 198 PCD patients were screened. The prevalence of scoliosis (Cobb [10°) and significant spinal asymmetry (Cobb 5-10°) was 8 and 23%, respectively. Curve convexity and Cobb angle were significantly different within both groups between situs inversus patients and patients with normal anatomy (P B 0.009). Moreover, curve convexity correlated significantly with organ orientation (P \ 0.001; / = 0.882): In 16 PCD patients with scoliosis (8 situs inversus and 8 normal anatomy), except for one case, matching of curve convexity and orientation of organ anatomy was observed: convexity of the curve was opposite to organ orientation. Conclusions This study supports our hypothesis on the correlation between organ anatomy and curve convexity in scoliosis: the convexity of the thoracic curve is predominantly to the right in PCD patients that were 'randomized' to normal organ anatomy and to the left in patients with situs inversus totalis.

Idiopathic Scoliosis as a Rotatory Decompensation of the Spine

“…(19,20) The direction of this horizontal-plane rotation changes with age and is related to a change in the distribution of internal body mass. (19,21,22) Once the spine decompensates into scoliosis, this preexistent rotation increases, following the already built-in pattern. The occurrence of preexistent rotation in the normal spine explains the predominance of right thoracic, left lumbar curves once the spine starts to decompensate, not only in idiopathic scoliosis.…”

“…Evidence for such a twist as a prerequisite has been demonstrated in the literature. (19)(20)(21)(22) The mechanics of deformation of the rods can explicitly show that the moments acting on the rod change as a function of the geometrical curvature of the rod. This explains different patterns of the coronal plane spinal deformity development and the relationship between the initial geometry of the spine that is sagittal profile and the deformation patterns.…”

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

“…The hypothesis that the convexity of the curve in idiopathic scoliosis is determined by organ distribution was recently confirmed in 2017 by Schlösser et al, who screened a unique population of primary ciliary dyskinesia patients with and without situs inversus totalis for scoliosis, retrieved 16 patients with this unique combination, and found a 94% match between organ distribution and scoliosis curve convexity. 43 In contrast to the normal spine, it has long been known that the scoliotic spine is a completely asymmetrical structure. 1 This was based on scoliotic specimens and experimental studies that have shown that asymmetrical growth of the neurocentral junctions of the vertebrae leads to vertebral rotation; in more detail, unilateral lag screw epiphysiodesis of the neurocentral junctions in a growing pig was shown to lead to transverse asymmetry and a rotational deformity, similar to AIS.…”

Manuelle Behandlung der Skoliose beim Erwachsenen

“…Die Untersuchungsergebnisse legenzumindest hypothetischnahe, dass vergleichbare Zusammenhänge im menschlichen Organismus bestehen können. Der für die manuelle Praxis wichtigste Beitrag der neueren For-schung hat allerdings mit ganz traditioneller Anatomie zu tun: Seit Kurzem gibt es wissenschaftliche Hinweise darauf, dass die Topografie der Organe eine wichtige Rolle bei zahlreichen Formen der Skoliose spielt [14].…”