Introduction: Scoliosis and other spinal deformities progressing in adolescence are seen as multifactorial in their etiology now with a broad spectrum of mainly internal factors.
Central nervous growth regulating mechanisms regain attention.
Objectives: Draw attention to important scientific work on spinal deformities and force regulating processes of growth. Establish the crucial role of the cord and roots in the blueprint, construction and guidance of growth of the spine. Connect older clinical relevant work on posture and treatment of deformities and science on neuro-vertebral growth relations. Hypothesis in pathways of deviation towards sub optimal form and the real deformations of the spine.
Study design: Direct and referential search in pre-Pub Med publications and books on the subjects, published in Europe.
Methods: Combination and deduction in written evidence in older scientific work. Search for incidental and partial support in contemporary literature.
Results: Scientific reports in mainly German and Dutch language before 1914 on the quintessence of what posture is, what it means in the human species, give excellent insight how spinal deformities can and will occur. In the work of Roth from Brno fundamental neurobiological explanation and experimental support was given for these clinical observations in pre-war Orthopedics.
Conclusion: The leading role of the central nervous system to control the musculoskeletal system in its growth and function declares how posture can be seen as the resultant of morphologic and functional interdependency in processing tensile forces as they are the three dimensional biomechanical manifestation of life and growth. The cultural change towards an increasing sedentary lifestyle of children is depicted as the main external factor in etiology of adolescent spinal deformations.
Significance: Disseminate this knowledge between (para-)medical professionals seems of paramount importance and will get orthopedics back in their original field of interest.