Diario de columna vertebral

The Biomechanics of Spinal Deformity in Adolescent Idiopathic Scoliosis

Abstract

Gregory S Van Blarcum, Scott C Wagner, Raymond M Meyer, Daniel G Kang and Ronald A Lehman

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.