Mechanism of production of scoliosis. A hypothesis.

On the basis of previous studies on the vertebral column and thoracic skeleton, the author generated a hypothesis for the mechanism of production of scoliosis. According to this hypothesis, vertical stability of the thoracic spine is maintained by equal support through the ribs from both sides due to the equal load brought to the lamin by both the ribs through the costotransverse articulations and ligaments. Any interference in this balancing mechanism will disturb the mechanism of spinal stability, and the spine will bend toward the more heavier loaded side at the intervertebral joints. On the basis of this hypothesis, mechanisms of production of scoliosis (both in experimental animals and humans) after removal of ribs on one side can be explained. Removal of the ribs from one side produces an imbalance in the symmetric weight transmission through the ribs on the two sides. Pathologic deformations within the vertebrae in scoliosis results from the asymmetric load and the altered route of the load transmission on the convex side of the curve.