Patients with mild scoliosis have good prognosis
The Journal of Family Practice. 2003 June;52(6):431-454
June 1, 2003|Family Medicine
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- BACKGROUND: Late-onset idiopathic scoliosis arises in otherwise normal children, usually after 10 years of age. Children are often screened for scoliosis, but controversy remains about its long-term prognosis. This historical cohort study assessed the 50-year prognosis of patients with untreated late-onset idiopathic scoliosis.
- POPULATION STUDIED: A total of 117 patients with late-onset scoliosis were enrolled at a university orthopedics clinic from 1932 to 1948. Patients with congenital, neuromuscular, and early-onset idiopathic scoliosis were excluded.
- STUDY DESIGN AND VALIDITY: The original cohort included 444 patients; 144 of these were located and 27 refused participation. Subjects were offered questionnaires, a physical examination, and radiologic studies.
- OUTCOMES MEASURED: The primary outcomes measured were mortality compared with US life-tables, prevalence of acute and chronic back pain, pulmonary symptoms, activities of daily living, depression, and body image. Quality of life and more specific functional status were not addressed.
- RESULTS: Of the 117 patients, everyone completed a questionnaire, 54 had a physical exam, and 80 had radiographs. The average follow-up was 51 years.
PRACTICE RECOMMENDATIONS
Patients with late-onset idiopathic scoliosis have only a modest increase in health problems compared with patients without scoliosis. Clinicians should keep this in mind when providing health education and offer reassurance and watchful waiting to patients with small curves at skeletal maturity.
More broadly, whether to screen for scoliosis depends on the performance of the screening test as well as evidence of whether treatment alters the natural history of scoliosis. The US Preventive Services Task Force has concluded that there is insufficient evidence to recommend routine screening.1
