Biological principles of adult degenerative scoliosis

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.

Automated summary

The global aging population has contributed to an increase in adult degenerative scoliosis (ADS), a spinal deformity that affects mainly females. ADS is characterized by intervertebral disc and facet joint degeneration, causing spinal imbalance, severe pain, and neurological deficits, thus reducing quality of life. Despite improved management, the molecular mechanisms underlying ADS remain unclear. This study investigates the molecular mechanisms of ADS, focusing on angiogenesis, inflammation, extracellular matrix remodeling, osteoporosis, sarcopenia, and biomechanical stress. The limitations and challenges in the field are discussed, along with the potential translational applications that may arise from a better understanding of these mechanisms.