{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:39:33Z","timestamp":1793936373800,"version":"4.8.0"},"reference-count":87,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T00:00:00Z","timestamp":1595376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,9,9]],"date-time":"2020-09-09T00:00:00Z","timestamp":1599609600000},"content-version":"vor","delay-in-days":49,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Many years of dedicated research into the etiology of idiopathic scoliosis have not led to one unified theory. We propose that scoliosis is a mechanical, rotatory decompensation of the human spine that starts in the transverse, or horizontal, plane. The human spine is prone to this type of decompensation because of its unique and individually different, fully upright sagittal shape with some preexistent transverse plane rotation. Spinal stability depends on the integrity of a delicate system of stabilizers, in which intervertebral disc stiffness is crucial. There are two phases in life when important changes occur in the precarious balance between spinal loading and the disc's stabilizing properties: (i) during puberty, when loads and moment arms increase rapidly, while the disc's \u201canchor,\u201d the ring apophysis, matures from purely cartilaginous to mineralized to ultimately fused to the vertebral body, and (ii) in older age, when the torsional stiffness of the spinal segments decreases, due to disc degeneration and subsequent laxity of the fibers of the annulus fibrosus. During these crucial periods, transverse plane vertebral rotation can increase during a relatively brief window in time, either as adolescent idiopathic or degenerative de novo scoliosis. Much more is known of the biomechanical changes that occur during disc aging and degeneration than of the changing properties of the disc during maturation. \u00a9 2020 American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4137","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T14:03:33Z","timestamp":1595426613000},"page":"1850-1857","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Idiopathic Scoliosis as a Rotatory Decompensation of the Spine"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6182-0315","authenticated-orcid":false,"given":"Ren\u00e9 M","family":"Castelein","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9172-2049","authenticated-orcid":false,"given":"Saba","family":"Pasha","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"},{"name":"Division of Orthopedic Surgery The Children's Hospital of Philadelphia Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8153-364X","authenticated-orcid":false,"given":"Jack CY","family":"Cheng","sequence":"additional","affiliation":[{"name":"Joint Scoliosis Research Center of The Chinese University of Hong Kong-Nanjing University The Chinese University of Hong Kong Shatin Hong Kong"},{"name":"Department of Orthopaedics and Traumatology, S. H. Ho Scoliosis Research Laboratory The Chinese University of Hong Kong Shatin Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Dubousset","sequence":"additional","affiliation":[{"name":"Acad\u00e9mie Nationale de M\u00e9decine Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,7,22]]},"reference":[{"key":"2024031419515183000_jbmr4137-bib-0001","first-page":"15","article-title":"Adolescent idiopathic scoliosis","volume":"1","author":"Cheng","year":"2015","journal-title":"Nat Rev Dis Prim."},{"issue":"17","key":"2024031419515183000_jbmr4137-bib-0002","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1097\/BRS.0b013e3181c7cb8c","article-title":"Clinical effectiveness of school screening for adolescent idiopathic scoliosis","volume":"35","author":"Luk","year":"2010","journal-title":"Spine."},{"issue":"5","key":"2024031419515183000_jbmr4137-bib-0003","doi-asserted-by":"crossref","first-page":"474","DOI":"10.14444\/6063","article-title":"Cost and clinical outcome of adolescent idiopathic scoliosis surgeries\u2014experience from a nonprofit community hospital","volume":"13","author":"Bozzio","year":"2019","journal-title":"Int J Spine Surg."},{"issue":"7","key":"2024031419515183000_jbmr4137-bib-0004","doi-asserted-by":"crossref","first-page":"e0160267","DOI":"10.1371\/journal.pone.0160267","article-title":"Anterior overgrowth in primary curves, compensatory curves and junctional segments in adolescent idiopathic scoliosis","volume":"11","author":"Schl\u00f6sser","year":"2016","journal-title":"PLoS One."},{"issue":"11","key":"2024031419515183000_jbmr4137-bib-0005","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1097\/BRS.0000000000001919","article-title":"Anterior spinal overgrowth is the result of the scoliotic mechanism and is located in the disc","volume":"42","author":"Brink","year":"2017","journal-title":"Spine."},{"issue":"12","key":"2024031419515183000_jbmr4137-bib-0006","doi-asserted-by":"crossref","first-page":"2259","DOI":"10.1016\/j.spinee.2018.05.005","article-title":"Anterior-posterior length discrepancy of the spinal column in adolescent idiopathic scoliosis-a 3D CT study","volume":"18","author":"Brink","year":"2018","journal-title":"Spine J."},{"key":"2024031419515183000_jbmr4137-bib-0007","doi-asserted-by":"crossref","DOI":"10.1016\/j.spinee.2020.03.005","article-title":"Anterior lengthening in scoliosis occurs only in the disc and is similar in different types of scoliosis","author":"de Reuver","year":"2020","journal-title":"Spine J"},{"key":"2024031419515183000_jbmr4137-bib-0008","first-page":"80","article-title":"Intervertebral disc biomechanics in the pathogenesis of idiopathic scoliosis","volume":"123","author":"Grivas","year":"2006","journal-title":"Stud Health Technol Inform."},{"key":"2024031419515183000_jbmr4137-bib-0009","article-title":"What a stranded whale with scoliosis can teach us about human idiopathic scoliosis. 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