THE ETIOLOGIC RELEVANCE OF 3-D PATHOANATOMY OF ADOLESCENT IDIOPATHIC SCOLIOSIS

ABSTRACT Despite many years of dedicated research into the etiopathogenesis of adolescent idiopathic scoliosis, there is still no single distinct cause for this puzzling condition. In this overview, we attempt to link knowledge on the complex three-dimensional pathoanatomy of AIS, based on our ongoing research in this field, with etiopathogenic questions. Evidence from multiple recent cross-sectional imaging studies is provided that supports the hypothesis that AIS has an intrinsic biomechanical basis: an imbalance between the biomechanical loading of the upright human spine due to its unique sagittal configuration on the one hand, and the body’s compensating mechanisms on the other. The question that remains in the etiology of AIS, and the focus of our ongoing research, is to determine what causes or induces this imbalance.摘要：尽管针对青少年特发性脊柱侧凸（adolescent idiopathic scoliosis, AIS）的发病机制已开展多年专项研究，但目前仍未明确这一疑难病症的单一确切病因。本综述基于本团队在该领域的持续研究，尝试将青少年特发性脊柱侧凸复杂的三维病理解剖结构相关认知与发病机制相关未解问题相结合。本文提供了多项近期横断面影像学研究的证据，支持青少年特发性脊柱侧凸具有内在生物力学基础这一假说：即人类直立脊柱因独特的矢状面形态所产生的生物力学载荷，与机体的代偿调节机制之间存在失衡。目前青少年特发性脊柱侧凸病因学中尚存的核心问题，同时也是本团队当前研究的重点，在于明确究竟是什么因素引发或诱导了这一失衡。