THE NATURAL HISTORY OF EARLY ONSET SCOLIOSIS

Abstract

Objective : Examination of treatment outcome in a mixed group with early onset scoliosis. Design : Retrospective review of patient data in order to plan a meaningful prospective study of treatment protocols. Background : Scoliosis presenting before age 10 years, whatever the classification, has potentially significant consequences for morbidity and mortality, yet is discussed less than the more benign adolescent form. Subjects: Patients with early onset idiopathic or syndromic scoliosis who were at least 15 years old at last review. Outcome measures: Cobb angle change and the incidence of non-operative treatment and of surgery. Results : There were 44 male and 74 female patients (19 IIS, 44 JIS and 55 syndromic) with follow-up 12.3 years SD 4.35 and mean Cobb angle progression from 26.6° to 47.21°. Non-operative treatment did not reduce the incidence of surgery either over-all (66.1%) or in individual groups (84.2% IIS, 63.6% JIS and 61.8% syndromic). Surgery in conservatively treated patients was at a later age (11.8 years SD 3.72) in comparison to those without (9.1 years SD 4.53), suggesting some advantage. Conclusion : While orthotic treatment cannot be shown to prevent surgery in this series, achievement of the more modest aim of delay until nearer the pubertal growth spurt would be an undoubted benefit. Further study is necessary to determine whether this is a therapeutic effect or artefact.