title: Top theories for the etiopathogenesis of adolescent idiopathic scoliosis.
abstract: BACKGROUND
  Despite considerable advances in the past few decades, there is no generally accepted "top theory or theories" of the etiology of adolescent idiopathic scoliosis (AIS). This article aims to provide an overview of the current main hypothetical "concepts" on the etiopathogenesis of AIS.
  
  
  METHODS
  An extensive literature review on hypothetical concepts on the etiology and etiopathogenesis of AIS.
  
  
  RESULTS
  Concepts of etiopathogenesis in AIS were summarized and highlighted under 6 subgroups: genetics factors, abnormalities in nervous system, abnormal skeletal growth, hormones and metabolic dysfunction, biomechanical factors, and environmental and life style factors. An integrative model on the etiopathogenesis of AIS is proposed.
  
  
  CONCLUSIONS
  The current knowledge is still fragmented and many fundamental questions have remained to be answered. In moving forward in the perusal of further advancement of our understanding of the etiopathogenetic mechanisms and future evidence-based prevention and management of AIS, multidisciplinary and multicenter innovative research collaboration is imminently important and necessary.
  
  
  CONCLUSIONS
  With a relatively comprehensive review on the current understanding on the etiology and etiopathogenesis of AIS, the article would help to stimulate further innovative thoughts, research, and especially collaborative research in this area of great interest.
authors.affiliation: Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong.
authors.forename: Wei Jun
authors.initials: WJ
authors.lastname: Wang
authors.forename: Hiu Yan
authors.initials: HY
authors.lastname: Yeung
authors.forename: Winne Chiu-Wing
authors.initials: WC
authors.lastname: Chu
authors.forename: Nelson Leung-Sang
authors.initials: NL
authors.lastname: Tang
authors.forename: Kwong Man
authors.initials: KM
authors.lastname: Lee
authors.forename: Yong
authors.initials: Y
authors.lastname: Qiu
authors.forename: Richard Geoffrey
authors.initials: RG
authors.lastname: Burwell
authors.forename: Jack Chun Yiu
authors.initials: JC
authors.lastname: Cheng
mesh_terms: D000293:Adolescent; D000818:Animals; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine; D006801:Humans; D008962:Models, Theoretical; D012107:Research Design; D012600:Scoliosis / Q000209:etiology* / Q000503:physiopathology; D013315:Stress, Psychological