Biomechanical factors in the etiology of idiopathic scoliosis: two etiopathological groups of spinal deformities.

Background. The paper constitutes a study of the biomechanical etiology of so-called idiopathic scoliosis. Material and methods. This research involved clinical material from 434 children with scoliosis, examined and treated in the years 1995-2002. Computer-assisted gait analysis was also added to the examination. Results. In idiopathic scoliosis, there is a real abduction contracture of the right hip, often connected with flexion and outward-rotation contracture of the right hip, or only a limited range of adduction. The right hip abduction contracture, structural or functional, is connected with the "contracture syndrome", Prof. Mau's "Siebenerkontrakturen Syndrom". Children with real abduction contracture of the right hip or adduction of 00 constitute the first etiopathological group of scoliosis, a double S-shaped scoliosis. There is initial rotation deformity with spinal stiffness; deformity, connected with gait, starts at age 3-4. Patients with only a difference in the adduction of both hips (15-250 adduction of the right hip, 35-500 adduction of the teft hip) constitute the second etiopathological group of scoliosis, C-shaped lumbar, lumbo-sacral, or lumbo-thoracic left convex scoliosis, usually diagnosed after age 10. Conclusion. In accordance with the respective biomechanical etiology of scoliosis, children with scoliosis and endangered with scoliosis should be given exercises to restore the flexibility of the spine. The paper underlines the importance of asymmetric rotational flexion-extension exercises. The understanding of the biomechanical etiology of idiopathic scoliosis enables prevention of the causes of this spinal deformity.