Figure 1.

Uncoupled, or asynchronous, neuro-osseous growth concept for AIS pathogenesis involving asynchronous growth of spine and spinal cord. Diagrammatic representation from the findings of Chu et al [1-4] showing how anterior spinal overgrowth (T1-T12) stretches the normal length spinal cord cranially and at the cauda equina leading to hypokyphosis from an anterior component of force (horizontal arrow [16]) with maladaptation of the growing thoracic spine to the tethered spinal cord which, with subtle neurologic dysfunction, forms a scoliosis. Diagram modified from Breig [17].