Etiology of Idiopathic Scoliosis: Current Trends in Research*

▹Current population studies characterize idiopathic scoliosis as a single-gene disorder that follows the patterns of mendelian genetics, including variable penetrance and heterogeneity. ▹The role of melatonin and calmodulin in the development of idiopathic scoliosis is likely secondary, with indirect effects on growth mechanisms. ▹Reported abnormalities of connective tissue, skeletal muscle, platelets, the spinal column, and the rib cage are all thought to be secondary to the deformity itself. ▹Although no consistent neurological abnormalities have been identified in patients with idiopathic scoliosis, it is possible that a defect in processing by the central nervous system affects the growing spine. ▹The true etiology of idiopathic scoliosis remains unknown; however, it appears to be multifactorial. Idiopathic scoliosis is a pathological entity of unknown etiology. Although the entity was first described by Hippocrates, the term idiopathic scoliosis was probably introduced in the middle of the nineteenth century by Bauer39; it was used by Nathan in 190967, defined by Whitman in 192293, included by Cobb in his classification19, and popularized by the Scoliosis Research Society40. Although most physicians who treat spinal deformities understand the term idiopathic scoliosis, the important questions concerning its etiology remain unanswered. The objectives of this paper are to provide an update on a number of aspects of the etiology of idiopathic scoliosis, to present an inventory of current investigational work, and to suggest directions for future research. The identification of etiological factors will depend on continued research in each of the areas discussed in this review. Further understanding of this disorder will enable the clinician to better predict prognosis and to aid in the development of more effective treatment modalities. This work represents an effort on the part of the Scoliosis Research Society Etiology Committee to promote an awareness of the …