School scoliosis screening, a program useful not only for the prevention of scoliosis. Part two: a clinical research tool for the study of the aetiology of idiopathic scoliosis.

  • Theodoros B GRIVAS Dr. Theodoros B. GRIVAS, MD PhD, Orthopaedic Surgeon, Former head of the Traumatology and Orthopaedic Department of “Tzaneio” General Hospital of Piraeus, Piraeus, Greece Email:;
Keywords: school scoliosis screening, aetiology, idiopathic scoliosis, environment, is prevalence, geographical latitude, menarche, melatonin, is pathogenesis, visual deficiency, age at menarche, curve laterality, brain, truncal asymmetry, thoracic cage, segmental thoracic ratios, segmental rib vertebra angles, segmental rib vertebra angle differences, growth, thoracic inertia, gait, double rib contour sign, rib index, lateral spinal profile, sagittal plane, intervertebral disc, cavus foot, somatometric parameters, surface topography, leg length inequality, BMI, epigenetics, parental age, IS concepts.


This report presents the contribution of the school scoliosis screening program on aetiology/scoliogeny of idiopathic scoliosis. A number of issues are discussed related to the analysis of collected data from scoliosis school screening , namely the study of the influence of environmental factors in IS prevalence, that is the geographical latitude, menarche and the role of melatonin in IS pathogenesis, the relevance of scoliosis in women with visual deficiency, the age at menarche and its relation to laterality of the curve, the role of the brain in truncal asymmetry and idiopathic scoliosis pathogenesis, the thoracic cage in normality and its role in IS pathogenesis. We present the introduction of segmental thoracic ratios method and of the segmental Rib Vertebra Angles and Rib Vertebra Angle Differences in thoracic radiographs. The relative narrowing of the chest during growth: a hypothesis involving pelvic and thoracic inertia in gait and the introduction of double rib contour sign and the Rib Index. The impact of the lateral (sagittal plane) spinal profile, the role of the intervertebral discs in IS pathogenesis and the association of cavus foot with IS are also discussed.  Additionally, the analysis of the somatometric parameters, the study of surface topography and the role of leg length inequality are presented. A pathophysiologic concept possibly common with IS is postulated studying the BMI in relation to the asymmetrical healthy adolescents. The parental age at birth is presented as a possible epigenetic factor/mechanism for the truncal asymmetry of a child. Finally, we summarize the outcomes and the hypothesized concepts related to IS scoliogeny, resulting from our SSS program, and our related publications on all the above discussed topics.


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Author Biography

Theodoros B GRIVAS, Dr. Theodoros B. GRIVAS, MD PhD, Orthopaedic Surgeon, Former head of the Traumatology and Orthopaedic Department of “Tzaneio” General Hospital of Piraeus, Piraeus, Greece Email:;

Dr Theodoros B. GRIVAS, MD, PhD Orthopaedic and Spinal surgeon, graduated the Medical School at “Aristotle” University of Thessaloniki, Central Macedonia, Greece. He completed his training in General Surgery, in Paediatric and Adult Orthopaedics and Traumatology in Greece and received the MD Diploma. He also received a PhD degree. He worked at the “University Hospital”, Queen’s Medical Centre, at Nottingham, “Harlow Wood” Orthopaedic Hospital, at Mansfield, UK, under Mr. JK Webb and Professor RG Burwell, at “Evangelismos” and “Thriasio” Hospital at Athens Greece. He is a member of the Hellenic Association of Orthopaedic Surgery and Traumatology and of numerous other scientific societies. He is a member and Traveling Fellow of both AAOS, AOA and SRS. He served as an IRSSD, SOSORT and Hellenic (Greek) Spine Society president. He completed several research projects, studied and implemented the School Screening program and established a National Training Center for school-screening examiners (, published numerous peer-review articles and chapters in books and was invited to lecture on various general orthopaedic and spinal topics. He wrote or was the editor of 9 books, and numerous (630) scientific (128 Medline indexed, see ) publications and presentations. He was scientific responsible/principal investigator or collaborator of 20 research projects, financed by Greek national or European sources (see also at ).
He served as the Chief Editor of BMC open access “Scoliosis and Spinal Deformities” former “Scoliosis” journal and is member of editorial board or reader for several peer-review journals. He severed as a member of the National Examination Committee for the specialty of Orthopaedics and Traumatology during 2019-2020. He is a member of the Crisis and Selection Council of Hellenic National Health System, the competent authority for the appointment of Orthopaedic Surgeons in State Hospital Positions, in the 2nd Health District of Piraeus and the Aegean.
He was the Director of the Orthopaedic and Traumatology Department at “Tzaneio” General Hospital of Piraeus, Greece. His department was invited to provide the “Trialect platform” Fellowship – Traineeship in Orthopaedics and Traumatology.