Scoliosis Convexity is Related to Organ Anatomy Tom

Scoliosis Convexity is Related to Organ Anatomy Tom P. C. Schlösser, Tom Semple, Siobhán B. Carr, Simon Padley, Michael Loebinger, Claire Hogg, René M. Castelein ICEOS 2016

80 -99% of AIS is right convex Theories on scoliosis convexity are: Brain asymmetry Asymmetrical organ distribution Right handedness

Rotation of the normal spine is to the right and matches with scoliosis convexity

Kouwenhoven et al. , 2007: Rotation of the normal spine is related to organ anatomy! Normal anatomy versus Situs inversus:

Hypothesis AIS curve convexity is to the right in patients with normal anatomy and to the left in situs inversus Optimal design: Normal situs Situs inversus

Prevalence of AIS with situs inversus is nihil AIS 2% Situs Inversus 0, 005% SI+Scoliosis 1/3. 000

Primary Cilliary Dyskinesia is a pulmonary syndrome with 50/50 distribution of organ anatomy 50%

Study population: Retrospective review of annual X-chest screening of 196 PCD patients: - 108 Normal anatomy - 84 Situs inversus - 4 Dextrocardia

196 PCD patients 46 (23%) Cobb >5° 16 (8%) Cobb >10 ° • 8 Situs solitus • 8 Situs inversus 7 of 8 right convex! 8 of 8 left convex! Chi-square P=0. 001

2 examples of PCD patients with scoliosis, with and without situs inversus

Conclusions: • Higher prevalence of scoliosis in PCD (8%), but data support the hypothesis that: • Distribution of organ mass appears to determine curve convexity in scoliosis