A Multi-Factorial Perspective on Idiopathic Scoliosis: Beyond Orthopedics
Main Article Content
Abstract
Idiopathic scoliosis, a complex spinal deformity, has long been viewed primarily through an orthopedic lens. However, recent research has unveiled a multitude of factors contributing to its development, including hormonal imbalances, bone density variations, emotional and digestive symptoms, genomic variants, and neurotransmitter abnormalities. This narrative review aims to highlight the multi-factorial nature of idiopathic scoliosis, emphasizing the common abnormalities that exist in patients with idiopathic scoliosis that occur outside of the vertebral column itself. Given that these abnormalities seem to be consistent with previously published etiopathological models of scoliosis development and progression, it is feasible to deduce that a more comprehensive idiopathic scoliosis treatment model, one that extends beyond traditional orthopedics to optimize patient care and outcomes, is needed. This treatment framework is proposed through a functional medicine model of patient management.
Article Details
How to Cite
MORNINGSTAR, Mark W..
A Multi-Factorial Perspective on Idiopathic Scoliosis: Beyond Orthopedics.
Medical Research Archives, [S.l.], v. 12, n. 11, nov. 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6078>. Date accessed: 12 dec. 2024.
doi: https://doi.org/10.18103/mra.v12i11.6078.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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27. Morningstar MW, Strauchman MN. Salivary Progesterone Levels in Female Patients with a History of Idiopathic Scoliosis: A Retrospective Cross-Sectional Study. Clin Pract. 2022; 12:326-332.
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30. Luo M, Zhang Y, Huang S, Song Y. The Susceptibility and Potential Functions of the LBX1 Gene in Adolescent Idiopathic Scoliosis. Front Genet. 2021 Jan 18;11:614984.
31. Montanaro L, Parisini P, Greggi T, Di Silvestre M, Campoccia D, Rizzi S, Arciola CR. Evidence of a linkage between matrilin-1 gene (MATN1) and idiopathic scoliosis. Scoliosis. 2006 Dec 18;1:21.
32. Balkhande PB, Lakkakula BVKS, Chitharanjan AB. Relationship between matrilin-1 gene polymorphisms and mandibular retrognathism. Am J Orthod Dentofacial Orthop. 2018; 153:255-261.e1.
33. Man GC, Wang WW, Yim AP, Wong JH, Ng TB, Lam TP, Lee SK, Ng BK, Wang CC, Qiu Y, Cheng CY. A review of pinealectomy-induced melatonin-deficient animal models for the study of etiopathogenesis of adolescent idiopathic scoliosis. Int J Mol Sci. 2014; 15:16484-99.
34. Morningstar, M. Neurotransmitter patterns in patients with adolescent idiopathic scoliosis (AIS). Scoliosis 2013; 8 (Suppl 2).
2. Kulis A, Goździalska A, Drąg J, Jaśkiewicz J, Knapik-Czajka M, Lipik E, Zarzycki D. Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis. Int Orthop. 2015; 39:1227-36.
3. Ishida K, Aota Y, Mitsugi N, Kono M, Higashi T, Kawai T, Yamada K, Niimura T, Kaneko K, Tanabe H, Ito Y, Katsuhata T, Saito T. Relationship between bone density and bone metabolism in adolescent idiopathic scoliosis. Scoliosis. 2015; 10:9.
4. Tanabe H, Aota Y, Nakamura N, Saito T. A histomorphometric study of the cancellous spinal process bone in adolescent idiopathic scoliosis. Eur Spine J. 2017; 26:1600-1609.
5. Han C, Zhou C, Zhang H, Yin P, Guo R, Wang W, Zhang Y, Cha T, Li G, Hai Y. Evaluation of bone mineral density in adolescent idiopathic scoliosis using a three-dimensional finite element model: a retrospective study. J Orthop Surg Res. 2023; 18:938.
6. Cheng Y, Yang H, Hai Y, Pan A, Zhang Y, Zhou L. Hounsfield unit for assessing asymmetrical loss of vertebral bone mineral density and its correlation with curve severity in adolescent idiopathic scoliosis. Front Surg. 2022 Sep 22;9:1000031.
7. Schlager B, Krump F, Boettinger J, Niemeyer F, Ruf M, Kleiner S, Beer M, Wilke HJ. Characteristic morphological patterns within adolescent idiopathic scoliosis may be explained by mechanical loading. Eur Spine J. 2018; 27:2184-2191.
8. Burwell RG, Clark EM, Dangerfield PH, Moulton A. Adolescent idiopathic scoliosis (AIS): a multifactorial cascade concept for pathogenesis and embryonic origin. Scoliosis Spinal Disord. 2016 Jan 30;11:8.
9. Park Y, Ko JY, Jang JY, Lee S, Beom J, Ryu JS. Asymmetrical activation and asymmetrical weakness as two different mechanisms of adolescent idiopathic scoliosis. Sci Rep. 2021; 11:17582.
10. Lee, S.B.; Chae, H.W.; Kwon, J.W.; Sung, S.; Lee, H.M.; Moon, S.H.; Lee, B.H. Is There an Association Between Psychiatric Disorders and Adolescent Idiopathic Scoliosis? A Large-database Study. Clin. Orthop. Relat. Res. 2021, 479, 1805–1812.
11. Cantele F, Maghini I, Tonellato M, Meneguzzo P, Favaro A, Masiero S. An Analysis of Eating Disorders in Adolescent Idiopathic Scoliosis: A Prospective Cross-sectional Study in a Female Population. Spine 2021; 46:440-446.
12. Payne WK 3rd, Ogilvie JW, Resnick MD, Kane RL, Transfeldt EE, Blum RW. Does scoliosis have a psychological impact and does gender make a difference? Spine 1997; 22:1380-4.
13. Lin T, Meng Y, Ji Z, Jiang H, Shao W, Gao R, Zhou X. Extent of Depression in Juvenile and Adolescent Patients with Idiopathic Scoliosis During Treatment with Braces. World Neurosurg. 2019; 126:e27-e32.
14. Tones M, Moss N, Polly DW Jr. A review of quality of life and psychosocial issues in scoliosis. Spine 2006; 31:3027-38.
15. Rushton PR, Grevitt MP. Comparison of untreated adolescent idiopathic scoliosis with normal controls: a review and statistical analysis of the literature. Spine 2013; 38:778-85.
16. Black, C.J.; Drossman, D.A.; Talley, N.J.; Ruddy, J.; Ford, A.C. Functional gastrointestinal disorders: Advances in understanding and management. Lancet 2020, 396, 1664–1674.
17. Lee SB, Chae H-W, Kwon J-K, Sung S, Moon S-H, Suk K-S, et al. Association of functional gastrointestinal disorders with adolescent idiopathic scoliosis. Children 2024, 11:118.
18. Morocz M, Czibula A, Grozer ZB, Szecsenyi A, Almos PZ, Rasko I, et al. Association study of BMP4, IL6, leptin, MMP3, and MTNR1B gene promoter polymorphisms and adolescent idiopathic scoliosis. Spine 2011; 36:E123–E30.
19. Qiu XS, Tang NLS, Yeung HY, Cheng JCY, Qiu Y. Lack of association between the promoter polymorphism of the MTNR1A gene and adolescent idiopathic scoliosis. Spine. (2008) 33:2204–7.
20. De Salvatore S, Ruzzini L, Longo UG, Marino M, Greco A, Piergentili I, Costici PF, Denaro V. Exploring the association between specific genes and the onset of idiopathic scoliosis: a systematic review. BMC Med Genomics. 2022; 15:115.
21. AlMekkawi AK, Caruso JP, El Ahmadieh TY, Palmisciano P, Aljardali MW, Derian AG, Al Tamimi M, Bagley CA, Aoun SG. Single Nucleotide Polymorphisms and Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis of the Literature. Spine 2023; 48:695-701.
22. Ru L, Zheng H, Lian W, Zhao S, Fan Q. Knowledge mapping of idiopathic scoliosis genes and research hotspots (2002-2022): a bibliometric analysis. Front Pediatr. 2023 Dec 4;11:1177983.
23. Yang MY, Chen K, Hou CL, Yang YL, Zhai X, Wei XZ, et al. RHOA Inhibits chondrogenic differentiation of mesenchymal stem cells in adolescent idiopathic scoliosis. Connect Tissue Res 2022; 63:475–84.
24. Morningstar M, Stitzel C, Strauchman M. Functional genomic variant patterns in Caucasian patients diagnosed with idiopathic scoliosis: a controlled, observational study. Medical Research Archives, 2019; 7:9.
25. Liu G, Wang LL, Wang XY, Yan ZH, Yang XZ, Lin M, et al. Whole-Genome methylation analysis of phenotype discordant monozygotic twins reveals novel epigenetic perturbation contributing to the pathogenesis of adolescent idiopathic scoliosis. Front Bioeng Biotechnol 2019; 7:8.
26. Zhu, X., Bai, W. & Zheng, H. Twelve years of GWAS discoveries for osteoporosis and related traits: advances, challenges and applications. Bone Res 2021; 9:23.
27. Morningstar MW, Strauchman MN. Salivary Progesterone Levels in Female Patients with a History of Idiopathic Scoliosis: A Retrospective Cross-Sectional Study. Clin Pract. 2022; 12:326-332.
28. Cecon E, Oishi A, Jockers R. Melatonin receptors: molecular pharmacology and signalling in the context of system bias. Br J Pharmacol. 2018:3263-3280.
29. Buchan JG, Alvarado DM, Haller GE, Cruchaga C, Harms MB, Zhang T, Willing MC, Grange DK, Braverman AC, Miller NH, Morcuende JA, Tang NL, Lam TP, Ng BK, Cheng JC, Dobbs MB, Gurnett CA. Rare variants in FBN1 and FBN2 are associated with severe adolescent idiopathic scoliosis. Hum Mol Genet. 2014; 23:5271-82.
30. Luo M, Zhang Y, Huang S, Song Y. The Susceptibility and Potential Functions of the LBX1 Gene in Adolescent Idiopathic Scoliosis. Front Genet. 2021 Jan 18;11:614984.
31. Montanaro L, Parisini P, Greggi T, Di Silvestre M, Campoccia D, Rizzi S, Arciola CR. Evidence of a linkage between matrilin-1 gene (MATN1) and idiopathic scoliosis. Scoliosis. 2006 Dec 18;1:21.
32. Balkhande PB, Lakkakula BVKS, Chitharanjan AB. Relationship between matrilin-1 gene polymorphisms and mandibular retrognathism. Am J Orthod Dentofacial Orthop. 2018; 153:255-261.e1.
33. Man GC, Wang WW, Yim AP, Wong JH, Ng TB, Lam TP, Lee SK, Ng BK, Wang CC, Qiu Y, Cheng CY. A review of pinealectomy-induced melatonin-deficient animal models for the study of etiopathogenesis of adolescent idiopathic scoliosis. Int J Mol Sci. 2014; 15:16484-99.
34. Morningstar, M. Neurotransmitter patterns in patients with adolescent idiopathic scoliosis (AIS). Scoliosis 2013; 8 (Suppl 2).