Introduction: The etiology and different treatment options in postural problems and spinal deformities are under ongoing discussion. A concise theorized system on the pathway of events in this field is lacking.
Purpose: To depict the role of a more optimal position and function of the thoracolumbar joint (and tensile conditions of the conuscauda area) in the human child. Distilling treatment modalities on experience with restoration of thoracolumbar lordosis in kyphotic and scoliotic deformities.
Methods: Own published scientific and practical experience with thoracolumbar lordotic intervention (TLI): 1) In vivo proof of the correcting force of TLI in double major scoliosis. 2) Retrospective study on radiological and clinical results with a TLI brace technique. 3) Case series with results and neuro-radiological consequences of restoration of lordosis by osteotomies at the TL-spine in kyfotic deformities. Combine these results with supportive (old) knowledge on basics of posture and with neurobiological science (neurovertebral growth relations of Roth) on features during growth.
Results: 1) A lordotic force at the TL-spine gives evident corrections of both curves in double major scoliosis. 2) A brace technique based on TLI gives obvious and lasting correction in coronal and sagital planes in deformities. 3) Pedicle subtraction osteotomies at the TL-spine are difficult but effective tools in serious spinal deformities.
Conclusion: A decrease in prevalence of (early) spinal degeneration and in seriousness of spinal deformities can be expected when the optimalisation processes as basic goal of growth in natural bodies (plant; animal) are recognized as major etiologic factors and respected in upbringing our children.
Significance: Taking care of these investigated and recognized processes on deviated tensile forces when spinal deformities and bad posture occur can become a mainstay of orthopedic guidance again.