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Abstract
Given the variety of anatomic and physical variations that exist, the biomechanics of Adolescent Idiopathic Scoliosis (AIS) comprise a complex topic. Representing the fundamental mechanism behind the three-dimensional deformities observed in this condition, AIS develops as a result of these complex interactions between pathoanatomy and the developmental biomechanics of the spine. The progressive nature of the deformity relates to the interplay between bony anatomical alterations and the surrounding soft tissue response. Various classification systems have evolved to better understand AIS and provide guidance for its management, and myriad techniques have been developed to address the correction of spinal deformity in these patients. For appropriately selected patients, the treating surgeon must exploit all biomechanical advantages available t counteract these deforming forces, and it is important that the biomechanics contributing to the progression of this condition be understood and corrected. All aspects of the case, including preoperative positioning and implant utilization, play a role in the amount of correction that can be obtained and maintained. These implants affect— and are affected by the forces present on the deformed spine, and manipulation of the surrounding anatomy may aid in obtaining the best surgical outcome.
Highlights
The Biomechanics of Spinal Deformity in Adolescent Idiopathic ScoliosisGregory S Van Blarcum, Scott C Wagner1,2*, Raymond M Meyer, Daniel G Kang and Ronald A Lehman1,2 1Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, USA 2Division of Orthopaedics, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA 3Uniformed Services University of the Health Sciences, Bethesda, USA
Spinal deformity biomechanics represent a complex topic, as many anatomic and physical variations exist that can affect the biomechanical behavior of the spinal column
The normal anatomy of the human thoracolumbar spine has evolved as an adaptation to the resultant axial and bending forces, and the dorsally-directed shear forces that occur; the profound lumbar lordosis and associated thoracic kyphosis noted in normal human spinal anatomy is not observed in other vertebrates, including most closely-related primate species [3]
Summary
Gregory S Van Blarcum, Scott C Wagner1,2*, Raymond M Meyer, Daniel G Kang and Ronald A Lehman1,2 1Department of Orthopaedics, Walter Reed National Military Medical Center, Bethesda, USA 2Division of Orthopaedics, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA 3Uniformed Services University of the Health Sciences, Bethesda, USA
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