Scoliosis and growth. Patterns of asymmetry in normal vertebral growth.

This study reviews published observations of asymmetrical appearance of primary ossification centres in human fetal vertebral arches. It reports studies of vertebral asymmetry in 39 vertebral columns of infants and children including asymmetry in pedicle length and vertebral arch height, asymmetry in neurocentral fusion, and vertebral body flattening on its left anterior aspect. It relates these patterns of asymmetry to the commonly observed left thoracic scoliosis of infancy and right thoracic scoliosis of adolescents and adults. It discusses the implications of these observed asymmetries of normal vertebral growth in the aetiology of scoliosis, and the possible influences of handedness and aortic pressure in the production of these vertebral asymmetries in adolescence.