Biological principles of adult degenerative scoliosis

Trends Mol Med. 2023 Sep;29(9):740-752. doi: 10.1016/j.molmed.2023.05.012. Epub 2023 Jun 21.

Abstract

The global aging population has led to an increase in geriatric diseases, including adult degenerative scoliosis (ADS). ADS is a spinal deformity affecting adults, particularly females. It is characterized by asymmetric intervertebral disc and facet joint degeneration, leading to spinal imbalance that can result in severe pain and neurological deficits, thus significantly reducing the quality of life. Despite improved management, molecular mechanisms driving ADS remain unclear. Current literature primarily comprises epidemiological and clinical studies. Here, we investigate the molecular mechanisms underlying ADS, with a focus on angiogenesis, inflammation, extracellular matrix remodeling, osteoporosis, sarcopenia, and biomechanical stress. We discuss current limitations and challenges in the field and highlight potential translational applications that may arise with a better understanding of these mechanisms.

Keywords: aging; low back pain; lumbar scoliosis; scoliosis; spinal deformity.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Aging
  • Female
  • Humans
  • Intervertebral Disc*
  • Lumbar Vertebrae
  • Quality of Life
  • Scoliosis* / genetics