<![CDATA[Adolescent Idiopathic Scoliosis (AIS) has traditionally been managed purely as a biomechanical structural deformity of the spine. However, recent evidence highlights the involvement of the central nervous system, particularly vestibular and sensorimotor dysfunction, in its pathogenesis. This systematic review aims to synthesize current literature on vestibular impairments and their impact on postural control in adolescents with AIS. A systematic literature search was conducted across electronic databases, including PubMed, ScienceDirect, and SpringerLink, to identify relevant studies. The inclusion criteria focused on articles evaluating vestibular function, sensorimotor integration, and postural control in patients with AIS, compared to either healthy controls or internal clinical parameters. The methodological quality and risk of bias of the included studies were appraised using the Joanna Briggs Institute (JBI) critical appraisal tools. Out of 137 initially screened records, 8 studies met the final inclusion criteria. Data synthesis reveals that AIS patients can actually maintain normal balance during simple static tasks due to a high-level of sensory compensation. However, their stability limits drop drastically when visual and proprioceptive inputs are manipulated. This instability strongly correlates with the severity of the Cobb angle. Structurally, imaging and neuro-otological evidence confirm the presence of anatomical asymmetries, such as abnormal lateral semicircular canal orientation and white matter disruptions in the corpus callosum. Furthermore, trials of neuromodulation interventions (combining peripheral and cortical stimulation) have proven effective in instantly reducing postural sway. AIS is a complex neurosensory syndrome driven by vestibular anatomical asymmetry and impaired central sensory integration, rather than purely a mechanical bone issue. Therefore, standard orthopedic management, such as bracing, should be complemented with routine neuro-otological screening and sensorimotor rehabilitation programs to address the root cause of postural instability.]]>
