The Pathophysiology of Scoliosis Across the Spectrum of Human Physiological Systems
Authors: Kerna Nicholas A. , Carsrud N.D. Victor , Zhao Xuan , Holets Hilary M. , Chawla Sudeep , Flores John V. , Ngwu Dabeluchi C. , Pruitt Kevin D. , Khan Maria , Roberson Rashad 
Published: March 2024

Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine. It can lead to various health issues, affecting mobility, respiratory function, and overall quality of life. There are several types of scoliosis, including idiopathic, congenital, neuromuscular, degenerative, and functional. The severity of scoliosis is measured by the degree of spinal curvature, typically expressed in degrees through a system known as the Cobb angle. Early detection and intervention are fundamental in managing scoliosis, as more severe forms may necessitate bracing or surgical intervention. Healthcare professionals must understand the different types of scoliosis and their unique characteristics to tailor appropriate treatment plans.Scoliosis can significantly impact various physiological systems, including the circulatory, digestive, endocrine, integumentary, lymphatic, muscular, nervous, and respiratory systems. In the circulatory system, scoliosis can cause hemodynamic changes, impaired venous return, cardiac strain, and pulmonary complications. In the digestive system, scoliosis can lead to gastric displacement, impaired intra-abdominal pressure, gastroesophageal reflux, and nutritional implications. The endocrine system can be affected by scoliosis, leading to neuroendocrine dysregulation, growth hormone abnormalities, cortisol dysregulation, and impact on thyroid function. Scoliosis can also affect the integumentary system, leading to pressure ulcers, altered skin sensation, and hygiene challenges. In the lymphatic system, scoliosis can cause lymphatic obstruction, impaired immune response, altered inflammatory responses, fibrosis, and secondary lymphedema. Scoliosis can affect the muscular system, leading to muscle imbalance, myofascial pain, respiratory muscle weakness, and mobility issues. The nervous system can also be impacted by scoliosis, leading to neural compression, central nervous system impact, neurological dysfunction, and coordination challenges. In the respiratory system, scoliosis can cause thoracic deformities, reduced lung compliance, ventilation-perfusion mismatch, respiratory muscle weakness, increased work of breathing (WOB), and an increased risk of respiratory infections.Recognizing and addressing the interplay between scoliosis and these physiological systems is integral for healthcare professionals to provide comprehensive care to individuals with scoliosis.Current research on scoliosis has made progress in diagnostic tools and techniques, including the use of imaging methods like MRI and X-ray, wearable sensors, and 3D reconstruction techniques for better evaluation of spinal motion and function, along with treatment strategies like Schroth exercises and braces, and management measures for respiratory and circulatory problems. However, there are limitations to current studies, such as the heterogeneity of scoliosis, compartmentalized approaches, limited longitudinal studies, reliance on retrospective data, and the need for standardized measures and diagnostic criteria. Future research prospects include advancements in genetic research, biomechanics, artificial intelligence and machine learning, longitudinal studies, non-invasive treatments, and multidisciplinary collaborations among researchers, clinicians, and technologists.