Scoliosis is often defined as a deformity of the spine in the frontal, or coronal plane, but it actually consists of a rather complex, three-dimensional (3D) deformity of the spine and rib cage, that can easily lead to pain, lowered self-image and compromised pulmonary function in its more severe forms. It carries a high burden of disease because of its life-long course and tendency to progress over time, and treatment is both demanding on the patient, as well as costly for society. Although, mostly because of radiographs, its definition is based on the coronal plane, the sagittal plane has been recognized as a very important part of the overall deformity for over a century, thanks to accurate observations of anatomists like Nicoladoni and others, already in the nineteenth century. More recently, classifications of scoliosis based on the changes in the sagittal plane have been proposed.
The human spine has a unique S-shaped sagittal profile, with a lordosis that already starts in the human pelvis and continues into the lumbar spine. That, and man’s ability to simultaneously extend hips and knees, brings the human center of gravity more dorsal than in any other species, quadrupedal and bipedal alike.
This has serious consequences for human spinal biomechanics, because forces are introduced that do not act on any other spine in nature. These forces decrease rotational stability and can to a large extent explain why adolescent idiopathic scoliosis (AIS), the form that we see most in everyday practice, occurs only in humans, and why girls predominate, especially in the more progressive forms of AIS. It also provides an explanation for the occurrence, in later life, of degenerative scoliosis.
In this Web Lecture, these concepts, that are based on much research, will be clarified. The role of the disc will be explained as the possible key to the problem of scoliosis, and there will be time for discussion and questions. Accreditation is applied for.
The webinar Update scoliosis – the sagittal plane in scoliosis have been applied for CME credits by EACCME®
European Accreditation Council
for Continuing Medical Education (EACCME)