Juvenile idiopathic scoliosis

Abstract

In summary, juvenile idiopathic scoliosis is defined as a structural lateral curvature of the spine of greater than 10° for which no etiology can be established presenting between ages 3 and 10 years old. Its diagnosis is one of exclusion of other possible etiologies. It is characterized by a higher prevalence in females and its natural history appears more progressive than its adolescent counterpart. After a review of the literature and our own experience, we recommend that patients with curves having a Cobb angle greater than 25° be orthotically treated. In curves that progress to greater than approximately 45°, a posterior spinal fusion is indicated. In selected very immature patients we occasionally attempt to support a progressive curve with an orthosis to allow for growth of the spine; however, a severe and rigid deformity should not be allowed to develop. Treatment of juvenile idiopathic scoliosis remains a challenge. The orthopaedist must maintain careful patient follow-up and be flexible to change the course of treatment if a curve progresses. Concomitant curve progression and spinal rotation after posterior spinal fusion in these young patients remains an interesting topic that requires further investigation. © 1991.