Physicochemical pathology
There have been some recent advances in the theory of pathogenesis:
- calmodulin, a molecule that regulates skeletal contractile proteins after binding with calcium, is increased dramatically in those with progressive curves relative to those with relatively stable scoliosis. Platelet assays of calmodulin could be used to advantage by predicting those who are likely to fare worse and require earlier treatment.
- there seems to be a disordered arrangement of microfibrillar elastic fibres in the ligamentum flavum of those requiring surgery for adolescent idiopathic scoliosis. The fibrils were also at a relatively lower density and there was a structural disruption in the glycoprotein fibrillin.
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