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

René M. Castelein


Despite many years of dedicated research into the etio-pathogenesis of adolescent idiopathic scoliosis, there is still not one distinct cause for this puzzling condition. By this overview we try to link knowledge on the complex three-dimensional pathoanatomy of AIS, based on our ongoing research in this field, to etio-pathogenetic questions. Evidence from multiple recent cross-sectional imaging studies is provided that supports the hypothesis that AIS has an intrinsic biomechanical basis: an imbalance between the biomechanical loading of the upright human spine due to its unique sagittal configuration on the one hand and the body’s compensating mechanisms on the other. What actually implies or induces this imbalance is the remaining enigma in the etiology of AIS, and is the focus of our ongoing research.