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| # | Findings | Objects/Materials | Method | The main limitations of the study | Authors |
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| 1 | F-actin-positive cells were observed in the outer anulus of scoliotic discs and appeared stellate or dendritic, rather than bipolar and fibroblastic. F-actin appeared more prominent on the convex side of the scoliotic curve than on the concave side | Specimens of 13 human intervertebral discs:
Normal—3;
Low back pain—4;
Spondylolisthesis—3;
Scoliosis—3 | Morphology of IVD cells was examined using confocal microscopy and labeling of such cytoskeleton components as F-actin and vimentin. | (1) Small amount of specimens.
(2) Statistical analysis was not performed
(3) Studied subjects were not matched by age and gender.
(4) Specimens were not matched by the spine level.
(5) Type of scoliosis was not specified | Johnson and Roberts, 2003 [214] |
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| 2 | Cells from anterior anulus of scoliotic discs had increased secretory activity and decreased proliferative activity. | The anterior annulus tissue of discs:
Scoliotic—5 (aged 16–26);
Degenerative—5 (aged 43–56);
Prolapsed discs—5 (aged 33–52) | Histology and transmission electron microscopy with immunostaining markers. | (1) Subjects gender was not taken into consideration.
(2) Statistical analysis was not performed. | Ford et al., 2002 [215] |
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| 3 | Morphologic disc degeneration in IS was associated with stronger anabolic matrix metabolism.
Higher mRNA expression of extracellular matrix molecules like collagen II, aggrecan, biglican, decorin, lumical, and chondromodulin was revealed. | Study groups:
Idiopathic scoliosis (11 female and 5 male aged 10–22 years);
Patients with acute trauma (2 female, and 5 male aged 28–55);
Autopsy control adolescents (4 male and 4 female aged 8 to 17 years);
Autopsy control adults (7 male and 3 female aged 47–77 years) | Histological examination.
Gene expression analysis. | (1) Studied subjects were not matched by age and gender. | Bertram et al., 2006 [216] |
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| 4 | Higher collagen Type II synthetic levels and increased total protein content with no matrix turnover. Scoliotic changes are due to an altered and ineffective synthetic response to a pathologic mechanical environment. | Specimens of IVD and vertebrae endplates:
(i) 15 scoliotic (female) aged 11–15 years;
(ii) 17 normal control subjects (no details)
| Discs and endplates were analyzed for their water, collagen, proteoglycan, and protein content.
Biochemical methods were used. | (1) The scoliotic tissue was analyzed mainly at the convex and central side of the disc where the tissue is experiencing tension and not compressive force
(2) Control group was not clearly identified. | Antoniou et al., 2001 [217] |
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| 5 | Cells obtained from scoliotic discs showed higher synthetic activity than cells from degenerative and herniated discs. | Studied subjects:
IS—6 patients (mean age—24.4 years);
Osteochondrosis—6 patients (mean age 42.8 years);
Disc herniation—6 patients (mean age 35.2 years) | Cultures of disc cells were studied.
Deoxyribonucleic acid content, hydroxyproline content, and proteoglycan synthesis were determined. | (1) Gender of the studied subjects was not taken into consideration.
(2) Studied subjects were not matched by age. | Stern et al., 2004 [218] |
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| 6 | In scoliotic discs, elastic fibers were sparse, and the collagen and elastic fiber networks were disorganized with loss of lamellar structure. Cell clusters (degenerative feature) were seen in scoliotic discs but not in age-matched control discs. | Studied subjects:
IS—3 female (age 12–22 years);
Neuromuscular—3 female (age 14–16 years);
Control—2 (1 female with spinal tumor aged 12 years; 1 male with trauma aged 17 years) | Micrographs of the sections of IVDs were examined by polarized light to visualize collagen organization. The elastic fiber network was visualized immunohistechemically or by histochemical staining with orcein. | (1) Small amount of cases and controls.
(2) Statistical analysis was not performed. | Yu et al., 2005 [219] |
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| 7 | In scoliosis, impaired regulation of collagen fibrillogenesis by lumican or fibromodulin may result in lamellar structure. | Studied subjects:
IS—3 female patients (13, 15, and 17 years old);
Normal control—2 male (20, 24 years old) | Specimens from medial (anterior, central and posterior) parts of L1–L3 discs were studied.
Ultrastructural relations among keratan sulfate proteoglycan, -elastin, collagen fibers, and elastic fibers were studied. | (1) Small case and control groups.
(2) Cases and controls were not matched by gender and age.
(3) Statistical analysis was not performed. | Akhtar et al., 2005 [220] |
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| 8 | Proteoglycan and water content were reduced in scoliotic discs, particularly toward concavity of the curve. The distribution of some collagen types differed in scoliotic discs. Calcification of the cartilage endplates and adjacent discs was revealed in scoliosis.
| Studied subjects:
Scoliosis—20 patients including 15 with IS, 4 with congenital, and 1 with unknown type. Age: 3–42 years (mean—14.4). Gender was not indicated.
Control—12 subjects. Age 17–83 (mean—58.1). Gender was not identified. | The morphology and composition of the IVD and vertebrae cartilage endplates were studied | (1) Case and controls were not matched by age and gender.
(2) Cases with IS and congenital scoliosis were not analyzed separately.
(3) Specimens were not matched by the spine level (T6–T10 for scoliosis; L1–L5 for controls).
(4) Statistical analysis was not performed. | Roberts et al., 1993 [221] |
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| 9 | A chondroadherin level decreased at the concave site of scoliotic discs | Studied subjects:
Scoliosis (AIS)—7 patients (5 female and 2 male), age 14–17 years.
Control—2 nonscoliotic subjects aged 29 and 87 years. Gender was not specified. | Specimens from scoliotic subjects were taken during surgery (1 T9/T10, 3 T12/L1, and 3 L1/L2 discs).
Control specimens were obtained during autopsy (2-L4/L5 discs) | (1) Small amount of cases and controls
(2) Cases and controls were not matched by age
(3) Cases and control specimens were not matched by the spine level
(4) Statistical analysis was not performed. | Haglund et al., 2009 [222] |
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