Scoliosis is an anomaly in the development of the back, the cause of which remains a mystery. Nothing to do with too heavy a satchel or bad standing. But the mystery is being clarified, in particular thanks to the Yves-Cotrel Foundation, dedicated to research on diseases of the spine.
For fifteen years, this foundation has financed and brought together teams of researchers from all over the world. And leads are starting to emerge. First of all in terms of genetics. Doctors have noticed that scoliosis is more frequent in some families. A collaboration between Pr Patrick Edery, geneticist at the CHU de Lyon, and a team from Montreal has shown that the defect of a gene on chromosome 5 is responsible for certain familial forms of scoliosis. But since these represent only a minority of cases, we had to look in other directions.
Scoliosis: the role of melatonin
Scoliosis appears to be a disease with multiple mechanisms that can be the cause or the consequence of the deformity. This is why research is oriented as much towards biomechanics (modeling of the deformation to propose indices of gravity) as towards the study of hormonal mediators.
The influence of female hormones would explain the predominance of scoliosis in women. Another, more unexpected hormone is also being researched in Japan: melatonin(the hormone of the sleep-wake rhythm), the reduction of which may play a role. We are also interested in a protein, osteopontin, the rate of which could help predict the course of the deformity during adolescence. A blood test is being evaluated in Canada and Asia.
The brain would also be involved …
Alterations in the organs of balance (inner ear) and asymmetries in the processing of sensory information by the brain have been highlighted. Tests are being studied to explore them. Here again, it is a question of looking for neurosensory factors capable of predicting the evolutionary nature of scoliosis, in order to treat in time those which are likely to evolve.
Rehabilitation of the vestibule (the organ of balance), using visual exercises to improve perception in space, is carried out in Lille by Dr Dominique Rousié. Possible after 6 years, it could stop the evolution of certain scoliosis at their onset.
Treatments offered to correct scoliosis
More than a simple lateral tilt, scoliosis is a deviation of the vertebrae from one another. It most often appears in early adolescence, a year or two before the first period, and always requires monitoring (examinations plus X-rays) to follow its progress.
- Physiotherapy : it can soften the spine and improve respiratory comfort, but it does not influence the progression of scoliosis.
- Wearing a corset: It is necessary for several months to prevent aggravation, when the back deviates too much.
- Sport practice : it is never advised against. However, the corset must be removed during the activity.
- Surgery : it is offered as a last resort if the scoliosis worsens despite the corset (1% of cases).
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