Biomechanical approach

In Utrecht, Professor René Castelein and his team have studied the role of the intervertebral disc in the progression of scoliosis. They have established that instability and deformation mainly take place in the intervertebral disc and not in the vertebral bodies, as previously assumed.
Meanwhile, at the Institut de Biomécanique Humaine Georges Charpak, Paris, the team led by Prof. Skalli and Claudio Vergari has been working on a severity index, a technique which, based on a specific X-ray, should make it possible to differentiate scoliosis that will progress severely and from the one which will not require surgery.

At Toulouse Institute of Fluid Mechanics, Prof. Pascal Swider and Dr. Tristan Langlais are working on the hypothesis that the evolution of idiopathic scoliosis is an unstable dynamic phenomenon, which, combined with non-homogeneous pathological remodeling of tissues, leads to a divergence in growth equilibrium. They are therefore working on the development of two models, with the aim of determining which scolioses have a high risk of progression:

• A mechanical model, by modeling the forces exerted on the spine.
• A metabolic model, via the disc cell nutrition process and associated tissue growth.

At the Hospital for Special Surgery in New York, Profs Roger Widmann and Howard Hillstrom use surface topology to study 196 scoliotic patients before and after surgery. The 3D surface topography parameters of vertebral alignment and symmetry are precise and reliable. They distinguish patients with scoliosis from healthy children, and show clear correlations of surgical outcome and severity of imbalance.

At the Centre Alpin de la Scoliose, Grenoble University Hospital, Prof. Aurélien Courvoisier and Prof. Olivier Daniel are working to identify predictive factors for the worsening of idiopathic scoliosis. Their study combines clinical follow-up of 600 patients with an analysis of scoliosis displacement fields and transformations during its evolution, in order to extract an evolutionary identity for each scoliosis.
At the Nuffield Orthopaedics Centre, Oxford, UK, Jeremy Fairbank’s team is conducting a large-scale epidemiological project: data from thousands of patients are being studied to identify the incidence of scoliosis and determine risk factors.

The selection of projects supported jointly with the Scoliosis Research Society widens the field of research. Prof. Ying Li, from Michigan, USA, is focusing on the long-term study of titanium debris in surgical patients. The project aims to address the effects on local bone mineralization and the possible accumulation of waste products in the blood or in certain organs.