Scoliosis as a Paradigm of Pathological Spinal Curvature: Molecular Mechanisms and Imaging Innovations

Abstract

Pathological spinal curvature encompasses a broad spectrum of deformities that arise from a complex interplay of genetic, molecular, and biomechanical factors. This review synthesizes current knowledge on the molecular underpinnings of spinal deformities, with a focus on the dysregulation of non-coding RNAs, aberrant activation of the Wnt signaling pathway, inflammatory cytokine imbalances, and epigenetic modifications. In parallel, the article provides a detailed overview of both conventional and emerging imaging techniques used in the clinical assessment of spinal curvature. Traditional radiographic methods, such as Cobb angle measurement and Ferguson’s method, are critically compared with advanced modalities—including surface topography, ultrasound imaging, and computer-aided 3D reconstructions—that promise enhanced diagnostic accuracy while minimizing radiation exposure. By bridging molecular insights with clinical imaging advancements, this review underscores the importance of an integrated diagnostic approach for early detection and effective management of scoliosis and related spinal deformities. The convergence of these disciplines not only enriches our understanding of the pathogenesis of spinal curvature but also lays the foundation for the development of personalized therapeutic strategies.