Adolescent idiopathic scoliosis (AIS) is a condition characterized by a 
three-dimensional structural deformity of the spine. It is the most common type 
of spine deformity occurring in children aged 10 to maturity. Although the 
etiology of AIS still remains unknown, the role of genetic factors in the 
development of idiopathic scoliosis is widely accepted. However, to date no 
causative genes of AIS have been identified. Recently, the semicircular canals, 
which are part of the inner ear, were found to be morphologically abnormal in 
idiopathic scoliosis patients. Here we hypothesized that genetic predisposition 
to inner ear anomalies in AIS patients may be a strong factor in the generation 
of idiopathic scoliosis. The proposed idea is that gene defects could impair the 
development of the semicircular canals. A malformation of semicircular canals 
might affect the transmission of sensory signal about rotational movement of the 
body to the central nervous system; leading to an alteration in the neuronal 
circuit of balance. This will in turn affect body posture and results in the 
initiation of the curvature of the spine. This hypothesis may provide new 
insights in the understanding of the pathophysiologic mechanisms of idiopathic 
scoliosis. It can also offer hopes for potential early prediction of scoliosis.