Does adolescent idiopathic scoliosis relate to vestibular disorders? A systematic review

Adolescent idiopathic scoliosis (AIS) is a tridimensional deformity of the spinal column. This frequent disease, which has no clearly identified pathogenic mechanism, can have serious consequences. It has been hypothesized that unilateral and isolated vestibular disorders could be the origin of AIS. The objective of this work is to verify this hypothesis and to establish a pathophysiological model.

We performed a Pubmed-NCBI search, for the period 1966-2013, crossing the keyword scoliosis with the following keywords: vestibular, labyrinthine, postural control.

This search retrieved 66 articles. Twenty controlled studies were considered for study. Their analysis showed discordant results. This review cannot confirm a link between isolated vestibular disorder and occurrence of development of scoliosis.

There is not enough evidence to show a link between unilateral, isolated, vestibular dysfunction and AIS. From these findings, we propose a more global pathophysiological concept, which involves a trouble of the orthostatic postural control, with disturbance in the multisensory integration of vestibular, visual and somesthesic inputs. AIS could be the consequence of a reorientation of the longitudinal body axis in accordance with an erroneous central representation of verticality. An assessment of the sense of verticality would allow evaluate this hypothesis.