The most exciting avenue of research is the effect of melatonin on scoliosis. Chickens and bipedal rats have had their pineal gland removed with a dramatic increase in incidence of scoliosis. Upon administration of melatonin the development of the scoliosis appears to be significantly decreased. Application of research on humans 2 in this area has recently started, though in the infancy this may be a promising treatment modality, which may limit progression of curves and surgical treatment. Postural roundback and Scheuermann's kyphosis congenital kyphosis would be the most common causes for spinal deformity on the lateral stance.
Postural kyphosis is flexible and gradual and usually can be corrected voluntarily by the patient.
Scheuermann's kyphosis and congenital kyphosis are more rigid and structural and usually represent a shorter sharper curve on forward bend. Spondylolesthesis is a condition characterized by the translation or forward displacement of one vertebral body over another, most commonly seen at the lumbar sacral junction. Alarming degrees of translation may be present with minimal symptoms. These patients may exhibit a waddling gait, transverse abdominal crease, flattened buttocks and flexion deformities of the hips and knees. The onset is rarely before age 5 and peak presentation is by 20 years of age.