Correlation between spinal deformity and craniofacial asymmetry: a literature review

Relevance. This literature review examines the association between spinal deformity and craniofacial asymmetry, with particular attention to the relationship between the facial midline (the “suture line”) and the direction of spinal curvature (the “scoliosis line”). Recent studies indicate that alterations of the axial skeleton are often accompanied by characteristic changes in the craniofacial complex, with both aesthetic and functional implications. The review covers publications from the past decade to synthesize the evidence, identify consistent patterns, and define priorities for further interdisciplinary research.

Materials and methods. The literature search was conducted in PubMed, Google Scholar, and eLIBRARY.ru. Search terms included “suture line,” “scoliosis line,” “craniofacial asymmetry,” “idiopathic scoliosis,” and related keywords. Original studies, clinical case reports, and systematic reviews employing radiography, cone-beam computed tomography (CBCT), and 3D scanning were included for objective morphometric assessment.

Results. Among adolescents with idiopathic scoliosis, >80% showed lateral deviation of the facial midline of ≥2 mm relative to the midsagittal plane defined by key craniofacial landmarks. In most cases, the direction of deviation corresponded to the concave or convex side of the scoliotic curve. An occlusal plane cant aligned with the direction of spinal curvature was also frequently observed. Taken together, these findings support a shared pathophysiological mechanism involving neuromuscular, biomechanical, and embryologic adaptive processes.

Conclusion. These data underscore a robust association between axial skeletal deformity and craniofacial asymmetry. Early identification of facial midline deviation—and its alignment with the scoliotic curve—may serve as a clinically useful indicator for interdisciplinary treatment planning. Further studies are needed to elucidate the mechanisms of interaction and to inform comprehensive therapeutic strategies targeting both spinal and craniofacial deformities.

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