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Still No Straight Answers about Scoliosis

Posted on: 08/20/2002
Scoliosis is a sideways curvature of the spine. It is a condition that often affects growing children, especially teenagers. Sometimes it is caused by another problem that was present first. This is true, for example, in the case of children with muscular dystrophy or cerebral palsy who also have scoliosis.

There is one group of adolescents with scoliosis of unknown cause. This is called adolescent idiopathic scoliosis (AIS). "Idiopathic" means that the cause is unknown. Many studies have been done looking for one single cause or for two or more factors linked together. Finding this will help direct treatment. Avoiding bracing and surgery is the goal.

Researchers have looked at many factors that could cause AIS. They have studied muscles, hormones, nerves, and even the brain as the start of this problem. Genetics has always been suspected. Since AIS occurs more often in families, inheritance may be possible. New technology to study genes is part of new research efforts.

One factor is clearly a part of AIS, and that is growth. Children and teens with AIS are taller than those without AIS. Children under age 12 with AIS grow faster than children the same age but without AIS. However, there are also many children in this age group who grow fast and don't get AIS. Something must trigger growth and other hormones in the AIS group, but no one knows what it is yet.

Despite many years of study, the cause of AIS is still unclear. Most likely, there are many factors added together that trigger this problem. Early, fast growth and genetics seem to be the most likely triggers. Abnormal brain activity is another possible cause. If doctors could predict who will get scoliosis, early and effective treatment may be possible.

References:
Uri Michael Ahn, MD, et al. The Etiology of Adolescent Idiopathic Scoliosis. In The American Journal of Orthopedics. July 2002. Vol. 31. No. 7. Pp. 387-395.

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