Maturation of the spine and its consequences for conservative treatment of adolescent idiopathic scoliosis

Idiopathic scoliosis (AIS) is a complex spinal deformity of unknown cause. It often involves lateral curvature, axial rotation and thoracic kyphosis, leading to significant physical, psychological and social challenges. This research examines spinal maturation, non-ionising imaging techniques, bracing treatment and the three-dimensional nature of scoliosis.
Spinal maturation is a critical factor in the development of scoliosis. Studies have shown delays in ossification and fusion of the ring apophysis in AIS patients compared to healthy individuals. In addition, differences in disc height and vertebral body shape have been observed between the sexes, suggesting potential biomechanical factors contributing to spinal instability.
Non-ionising imaging modalities offer promising alternatives to traditional radiography for the assessment of AIS. Ultrasound and MRI-based synthetic CT (sCT) have demonstrated accuracy in measuring spinal curvature, assessing bone mineral density and detecting vertebral wedging. These techniques provide valuable information without the risks associated with ionising radiation.
Braces are a common treatment for scoliosis. While studies have shown the effectiveness of braces in preventing curve progression and reducing the need for surgery, there is a need for more standardised research and larger sample sizes. Understanding the biomechanical principles underlying brace therapy may help to optimise treatment outcomes.
The three-dimensional nature of scoliosis involves a complex interplay between lateral curvature, axial rotation and thoracic kyphosis. Analysis of these components can provide insight into the patterns of spinal deformity and inform future treatment strategies.
In conclusion, this work provides valuable insights into the aetiology, diagnosis and treatment of idiopathic scoliosis. By advancing our understanding of spinal maturation, imaging techniques and bracing therapy, we can improve the management of this complex condition and improve the quality of life of those affected.