The metabolic basis of adolescent idiopathic scoliosis: 2011 report of the “metabolic” workgroup of the Fondation Yves Cotrel

Abstract

ObjectiveThe purpose of this review is to elucidate the metabolic processes involved in the pathogenesis of adolescent idiopathic scoliosis (AIS) in light of research by the present authors as well as current literature.MethodsPathogenetic mechanisms involved in AIS were modeled as (a) a form of neuromuscular scoliosis (in conjunction with an adverse mechanical environment such as bipedality), in which hormonal and other chemical factors act as regulators of skeletal muscle tone and function; (b) as a consequence of an abnormality in growth of the spinal column (in conjunction with an adverse mechanical environment such as bipedality), in which hormones and other chemical factors act as regulators of growth; and (c) as a mechanical failure of one side of the vertebral column due to a defect in trabecular formation or mineralization (in conjunction with an adverse mechanical environment such as bipedality); in which hormonal and other chemical factors act as regulators of bone formation, mineralization and/or resorption.Results and conclusionCurrent evidence supporting these models individually or in combination is discussed.

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

“…For example, Machida et al studied the onset of scoliosis in pinealectomized chickens and Lambert et al in frogs after unilateral vestibular organ removal [42], [43]. It can be questioned, however, whether findings in animal models with iatrogenic scoliosis can be translated to humans, because natural development of idiopathic scoliosis cannot be found in any other vertebrate than man, and no invasive procedures are normally required to cause it [44]–[46]. Therefore, the identified data of cross-sectional studies as well as data from animal models do not clearly support the hypotheses that the described abnormalities play a role in the etio-pathogenesis of idiopathic scoliosis.…”

Adolescent idiopathic scoliosis: evidence for intrinsic factors driving aetiology and progression

“…A number of theories have been proposed regarding the cause of AIS, including metabolic [1] and biomechanical [21] hypotheses, and several tissue types have been implicated in its pathogenesis, including bone, intervertebral discs and paravertebral muscles. The consensus is therefore that AIS is a multifactorial disease [12], with increasing evidence from genetic studies for the central role of intrinsic factors in contributing to its pathology and progression.…”

Association of Calcium and Phosphate Balance, Vitamin D, PTH, and Calcitonin in Patients With Adolescent Idiopathic Scoliosis

“…7,16 In each individual case of AIS, most of mentioned factors are involved in the disease onset and progression. 17,18 Vitamin D exists in 2 different forms, named D3 and D2. The D2 is a plant-derived product, available in supplements and fortified food.…”