The contribution of the intervertebral disk to the scoliotic deformity.

We have put forward a number of questions about the role of the intervertebral disk in idiopathic scoliosis which are based on experimental evidence and current connective tissue research. It is regrettable that the last two decades have not seen a single major advance in the treatment of scoliosis based on a scientific understanding of the etiology and mechanisms of curve progression. The efficacy of early detection and surgical techniques cannot be denied but orthopedic surgery is not relieved of the responsibility of pursuing the causation and pathogenesis of scoliotic curvature. Spinal fusion for scoliosis cuts across the fundamental principle of orthopedic surgery--the preservation of musculoskeletal function--a maximum which Trueta enunciated so strongly through his surgical lifetime. Clearly, a sacrifice of spinal mobility is not a final acceptable solution to the malady.