Review

RECENT ADVENCES IN ETILOGY OF IDOPATHIC SCOLIOSIS

  • İ. Teoman BENLİ
  • M. Tibet ALTUĞ

J Turk Spinal Surg 2010;21(2):171-190

Although idiopathic scoliosis is basically defined as lateral deviation of vertebral column, regarding the data acquired during last 30 years, it is defined as a three dimensional deformity characterized by deformation of physiologic curves in the sagittal plane and axial rotation of the apex. Historically, the disease has been defined long time ago, but most of the theories about the etiology were not proved. First studies have been supported multifactorial genetic transition. On the contrary the most respected theory of the last years was existence soft tissue abnormality, neurologic and neuroendocrine disorders. Low melatonin level has been proposed as a reason for disorder in spinal column development causing scoliosis, relying upon the studies showing the development of scoliosis in the chickens with pinealectomy. The argument of platelet dysfunction and insufficient effect of calmodulin, a receptor protein, regulating the contractile proteins of paravertebral muscles as a cause of idiopathic scoliosis, has been based upon the studies of last years. On the other hand, CNS and cerebellar disorders and diminution in some deep senses like vibration and proprioception have been shown in idiopathic scoliosis patients. Important developments in genetic studies took place in last 5 years. The disease has been shown to be related with many genotypic polymorphisms and idiopathic scoliosis almost has been proved to be a genetic disorder of having dominant inheritance and heterogenic penetrans. Nevertheless, the gene defects in the 1st, 5th, 6th, 7th, 8th, 9th, 12th, 13th, 14th, 15th and 17th chromosomes are defined as candidate genes for the etiology of the disease. Today, the interest is on the genetic researches focusing on polymorphic screening tests related with progression. It seems that; in the near future, with the help of selective fertilization, the decrease in the incidence of scoliosis, early diagnosis and easier treatment of progressive curves and may be, after understanding the causing gene defect completely, the medical treatments for prevention or slowing down the disease will not be a dream.

Keywords: Idiopathic scoliosis, etiology, etiopathogenesis, genetics,