The Diurnal Variation “accordion”-like Phenomenon of Wedged Intervertebral Discs: A Progression Factor in Idiopathic Scoliosis - Abstract
This report presents a concept for idiopathic scoliosis (IS) progression, which refers to the role of the diurnal variation on the asymmetric water distribution of the eccentric nucleus
pulposus of the deformed scoliotic IVD, and the subsequent alteration of the mechanical environment, due to caused intermittent forces, on the adjacent vertebral growth plates. The
result of these intermittent forces, due to the diurnal variation, is an asymmetrical vertebral growth and progression of the deformity. This is terms the “accordion-like phenomenon”.
The concisely discusses data used to lend support to the presented concept, relate to the mechanobiology, the mechanotransduction process, and fundamentals of the embryology
and biology of the spinal column. It also relates to the normal and deformed intervertebral disc, the diurnal variation phenomenon, concepts of IS scoliogeny, the three-joint complex
concept, the sleep phases and muscular tone. This background knowledge tries to make clear and apprehensible the concept of “the diurnal variation accordion-like phenomenon of
wedged intervertebral discs”, which is argued to constitute a key progression factor in IS. This concept seems to be original, existent and it will clinically be very useful for tailoring the
treatment of the children suffering IS. The treatment methods currently used to reverse this progression of the IS mechanism are also mentioned. The final great benefit for this group
of children will be an unfused spine, as mother nature created it, yet the economies of the national health systems, will be prevented by the high expenditures of traditional surgical
treatment, if non operative treatment will properly be applied, based on this concept.