TNFSF11 and scoliosis: Additionally, OPG contributes to bone metabolism and exerts significant effects on immune response, vascular protection, and other physiological processes.[31] Animal studies have shown that mice lacking OPG display muscle frailty and selective muscle shrinkage.[32] Bonnet demonstrated that inhibiting RANKL and supplementing OPG can enhance muscle robustness and recuperate bone density in mice with osteoporosis.[33] We hypothesize that low levels of OPG may increase the risk of scoliosis by affecting bone mass.