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Otolith Dysfunction as a Possible Cause for the Development of Idiopathic Scoliosis

Pollak, Lea MD*; Shlamkovic, Natan MD; Minewicz, Alla MD*; Mirovsky, Yigal MD

Journal of Pediatric Orthopaedics: April/May 2013 - Volume 33 - Issue 3 - p 293–297
doi: 10.1097/BPO.0b013e31827c0643

Background: To investigate whether otolith system, as a major contributor to muscles for postural control, might play a role in the pathogenesis of idiopathic scoliosis (IS).

Methods: Cervical vestibular-evoked myogenic potentials (VEMP) testing was applied to investigate the otolith function in patients with IS. Twenty-nine healthy patients (mean age 13.5±2.5 y, 4 males) were included. In all but 2 patients, the major curve deviation was to the right and the mean angle deviation was 49.7±21.6 degrees. Nineteen age-matched individuals (10 males) served as controls.

Results: The P13 (first positive wave) latencies were comparable in both groups. Patients with IS had significantly longer N23 (first negative wave) latencies than controls. A high correlation between the age and N23 latencies on the right was found in IS patients. A link between the scoliosis angle and VEMP latencies could not be demonstrated.

The VEMP amplitudes were higher in patients than in controls, whereas the amplitude asymmetry ratio was similar in both groups.

Conclusions: This work brings further evidence for vestibular abnormalities in patients with IS. Prospective studies are needed to elucidate a possible causative relationship between otolith dysfunction and the development of scoliosis.

Level of Evidence: III.

Departments of *Neurology


Orthopedic Surgery, The Assaf Harofeh Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, Nes Ziona, Israel

None of the authors received financial support for this study.

The authors declare no conflict of interest.

Reprints: Lea Pollak, MD, Department of Neurology, The Assaf Harofeh Medical Center, Sackler Faculty of Medicine, University of Tel Aviv, Kibutz Galuyot 4, Nes Ziona 74012, Israel. E-mail:

© 2013 Lippincott Williams & Wilkins, Inc.