The role of birth trauma of the сervical Spine in the pathogenesis of idiopathis scoliosis: integration of neurological and biomechanical aspects.A review.



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Background: Idiopathic scoliosis (IS) remains one of the most common and complex orthopedic conditions in children and adolescents. Despite the recognized role of genetic, hormonal, and environmental factors, the triggering mechanism for the onset of deformity in early childhood remains a subject of debate.
Aim: To analyze the global literature on intrapartum cervical spine trauma, which acts as a precipitating factor for the development of idiopathic scoliosis in genetically predisposed patients.
Materials and metohods: A systematic analysis of publications in PubMed, Google Scholar, eLibrary, and CyberLeninka databases covering the period 2010–2024 on the etiology of IS was conducted, with an emphasis on studies examining the relationship between complicated births, cervical spine biomechanics, and the subsequent development of spinal deformity.
Results: This review summarizes and analyzes current literature on the potential role of intrapartum injury to the craniovertebral junction (C0-C2) in the pathogenesis of idiopathic scoliosis, integrating neurological, biomechanical, and genetic aspects. It has been established that mechanical stress on the cervical spine during childbirth (during breech presentation, rapid/protracted labor, and the use of obstetric assistance) can cause microdamage to dural structures, brainstem ischemia, and dysfunction of the reticulospinal tracts. This leads to muscle tone asymmetry, which, in the context of the pubertal growth spurt and genetic predisposition, translates into persistent triaxial spinal deformity. An integrative model of the pathogenetic cascade is proposed, explaining the latency period and subsequent progression of IS.
Conclusions: Intrapartum cervical trauma is a significant, although not the only, trigger for the development of IS. An integrated approach, including perinatal history analysis, early genetic screening, and ultrasound monitoring of the craniovertebral region in children at risk, can form the basis for developing strategies for the primary prevention of idiopathic scoliosis.

 

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Marina Vinderlih

Mari State University

编辑信件的主要联系方式.
Email: vinderlikh@yandex.ru
ORCID iD: 0000-0002-9855-548X
SPIN 代码: 9943-2150

Associate Professor, Candidate of Medical Sciences, Department of Surgical Diseases

俄罗斯联邦, 1 Lenin Square,424000 Yoshkar-Ola, Mari El Republic, Russia;

Sergey Валентинович Vissarionov

H. Turner National Medical Research Center for Children’s Orthopedics and Trauma Surgery

Email: vissarionovs@gmail.com
ORCID iD: 0000-0003-4235-5048
SPIN 代码: 7125-4930

MD, PhD, Dr. Sci. (Med.), Professor, Corresponding Member of RAS

俄罗斯联邦, 64-68 Parkovaya str., Pushkin, Saint Petersburg, 196603

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