What a Stranded Whale With Scoliosis Can Teach us About Human Idiopathic Scoliosis

Scoliosis is a deformation of the spine that may have several known causes, but humans are the only mammal known to develop scoliosis without any obvious underlying cause. This is called ‘idiopathic’ and is the most common type. Recent observations showed that human scoliosis, regardless of its cause, has a relatively uniform three-dimensional anatomy. We hypothesize that scoliosis is a universal compensatory mechanism of the spine, independent of cause and/or species. We had the opportunity to study the rare occurrence of scoliosis in a whale ( Balaenoptera acutorostrata ) that stranded in July 2019 in the Netherlands. A multidisciplinary team of biologists, pathologists, veterinarians, taxidermists, radiologists and orthopaedic surgeons conducted necropsy and imaging analysis. (Dorso-)lateral blunt traumatic injury to two vertebrae caused an acute lateral deviation of the spine, which had initiated the development of compensatory curves in regions of the spine without anatomical abnormalities. Three-dimensional analysis of these compensatory curves showed strong resemblance with different types of human scoliosis, amongst which idiopathic. This suggests that any decompensation of spinal equilibrium can lead to a uniform response, regardless of underlying cause or species. The unique biomechanics of the upright human spine, with significantly decreased rotational stability, explains why only in humans this universal mechanism of scoliosis can occur without an obvious cause, and is thus still called ‘idiopathic’.