Congenital scoliosis in a newborn baby. Image: Jog et al, 2002, Postgrad. Med. J.

Congenital scoliosis is a condition in which the newborn spine is curved abnormally, with fused or abnormally shaped vertebrae. It is commonly associated with rib abnormalities. While the causes of congenital scoliosis are currently unknown, there is evidence from some clinical conditions that fetal movements may play a key role in development of the spine. Spine abnormalities have been reported in cases of fetal akinesia deformation sequence (FADS), where the fetus doesn’t move at all, and congenital scoliosis is much more common in babies with arthrogryposis (multiple joint shape abnormalities), a syndrome which is strongly linked to abnormal fetal movements.

In work funded by the Leverhulme Trust and by the ERC, we investigate the link between fetal movements and development of the spine and ribs, using chick and mouse models of abnormal fetal movements. 

We have showm that:

  • Prolonged rigid paralysis induces severe defects in the developing chick spine, including curvature abnormalities, posterior and anterior vertebral fusions, and altered vertebral shape
  • The earlier in development paralysis is started, the more severe the abnormalities
  • Flaccid paralysis does not affect spinal curvature or vertebral segmentation.
  • Just one day of paralysis in the chick embryo is enough to induce severe abnormalities in spine and rib development
  • Single-day immobilisation at embryonic day 3 or 4 resulted in the most pronounced spinal curvature abnormalities, multiple wedged vertebrae and segmentation defects, while single-day immobilisation at E5 led to the most severe rib abnormalities.
  • Vertebral segmentation defects were subsequent to earlier vertebral body shape and spinal curvature abnormalities, while rib formation (although delayed) was independent from thoracic vertebral shape or curvature changes.
  • In mouse embryos, notochord involution happens normally when skeletal muscle is non functional. However, vertebral segmentation and disc structure depend upon embryonic muscle forces.


Levillain, A., Ahmed, S., Kaimaki, D., Schüler, S., Barros, S. Labonte, D., Nowlan, N.C., 2021. Prenatal muscle forces are necessary for vertebral segmentation and disc structure, but not for notochord involution in mice. European cells & materials, 41, pp. 558–575.

Levillain A, Rolfe RA, Huang Y, Iatridis JC & Nowlan NC. “Short-term fetal immobility temporally and progressively affects chick spinal curvature and spinal anatomy, and rib development”. European Cells & Materials 2019 Vol. 37 (pp 23-41) (link to pdf)

graphical abstract Aurelie

Rolfe RABezer JHKim TZaidon AZ, Oyen ML, Iatridis JC, Nowlan NC, “Abnormal fetal muscle forces result in defects in spinal curvature and alterations in vertebral segmentation and shape”, 2017. Journal of Orthopaedic Research 35 (10), pp. 2135–2144. (link)

Effects of paralysis on curvature of the chick spine
Effects of paralysis on segmentation of the vertebrae