{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T02:04:10Z","timestamp":1790129050010,"version":"4.0.1"},"reference-count":134,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T00:00:00Z","timestamp":1712620800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>In this opinion article, there is an analysis and discussion regarding the effects of growth on the spinal and rib cage deformities, the role of the rib cage in scoliogeny, the lateral spinal profile in adolescent idiopathic scoliosis (AIS), the genetics and epigenetics of AIS, and the interesting and novel field investigating the sleep impact at nighttime on AIS in relation to the sequence of the scoliogenetic changes in scoliotics. The expressed opinions are mainly based on the published peer-reviewed research of the author and his team of co-authors. Based on the analysis noted above, it can be postulated that the vertebral growth changes in the spine during initial idiopathic scoliosis (IS) development are not primary-intrinsic but secondary changes. The primary cause starting the deformity is not located within the vertebral bodies. Instead, the deformations seen in the vertebral bodies are the secondary effects of asymmetrical loads exerted upon them, due to muscular loads, growth, and gravity.<\/jats:p>","DOI":"10.3390\/jcm13082163","type":"journal-article","created":{"date-parts":[[2024,4,9]],"date-time":"2024-04-09T08:55:12Z","timestamp":1712652912000},"page":"2163","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Are the Spinal Changes in the Course of Scoliogeny Primary but Secondary?"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3018-5168","authenticated-orcid":false,"given":"Theodoros B.","family":"Grivas","sequence":"first","affiliation":[{"name":"Trauma and Orthopaedic Department, Former Head, \u201cTzaneio\u201d General Hospital of Piraeus, 185 36 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2428-5250","authenticated-orcid":false,"given":"Elias","family":"Vasiliadis","sequence":"additional","affiliation":[{"name":"3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, 145 61 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Mazioti","sequence":"additional","affiliation":[{"name":"\u201cTzaneio\u201d General Hospital of Piraeus, 185 36 Piraeus, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Despina","family":"Papagianni","sequence":"additional","affiliation":[{"name":"School Nurse, Special Primary School of Rafina, 190 09 Rafina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristea","family":"Mamzeri","sequence":"additional","affiliation":[{"name":"TOMY Attica Square, 104 45 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michail","family":"Chandrinos","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Gen. Hospital of Argolida-N.M. Argous, 212 00 Argos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Vynichakis","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Gen. Hospital of Argolida-N.M. Argous, 212 00 Argos, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Athanasopoulos","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Peristeri Medical Group, 121 32 Peristeri, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paschalis","family":"Christodoulides","sequence":"additional","affiliation":[{"name":"Department of Radiology, General Hospital of Paphos, Paphos 8026, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7065-8401","authenticated-orcid":false,"given":"Nikola","family":"Jevtic","sequence":"additional","affiliation":[{"name":"Scolio Centar, 403916 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samra","family":"Pjanic","sequence":"additional","affiliation":[{"name":"Department of Paediatric Rehabilitation, Institute for Physical, Rehabilitation Medicine and Orthopaedic Surgery \u201cDr Miroslav Zotovic\u201d, 78000 Banja Luka, Bosnia and Herzegovina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danka","family":"Ljubojevic","sequence":"additional","affiliation":[{"name":"Scolio Centar, 403916 Novi Sad, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Savvidou","sequence":"additional","affiliation":[{"name":"First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, \u201cATTIKON\u201d University General Hospital, Rimini 1, 124 62 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3265-5522","authenticated-orcid":false,"given":"Angelos","family":"Kaspiris","sequence":"additional","affiliation":[{"name":"3rd Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, KAT Hospital, 145 61 Athens, Greece"},{"name":"Laboratory of Molecular Pharmacology, Department of Pharmacy, School of Health Sciences, University of Patras, 265 04 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarrett","family":"Grunstein","sequence":"additional","affiliation":[{"name":"Chiropractic Center Livingston, 340 E Northfield Rd # 2E, Livingston, NJ 07039, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1007\/s00586-010-1637-x","article-title":"Rib length asymmetry in thoracic adolescent idiopathic scoliosis: Is it primary or secondary?","volume":"20","author":"Zhu","year":"2011","journal-title":"Eur. 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