Idiopathic scoliosis: evaluation of results

Natural history studies in idiopathic scoliosis must be known to assess the effectiveness of treatment. Natural history is better known to day for mil d angulations but as far as scoliosis are operated on for greater angulatio ns natural history of scoliotic population with Cobb angle greater than fif ty degrees is less and less available, Effectiveness of school screening is debated because of over-referral of either non scoliotic children or patie nt wit mild non evolutive scoliosis. Attempt to find any criteria for evolu tive scoliosis was disappointing. Only scoliosis with Cobb angle greater th an thirty five degres during growth spurt is defined as an evolutive scolio sis with a 95% confidence interval. Scoliotic curves show a tendency to pro gress even during adult life especially of the Cobb angle is over thirty de gres at skeletal maturity. Effectiveness of bracing is established for Cobb angle over thirty degres. Comparing a natural history and the results of b racing for mild idiopathic scoliosis controversies remain according to the effectiveness of bracing. Scoliotic population is more at risk for back pai n than a population based control group. In severe idiopathic scoliosis non operated patients ar mor eat risk for back pain than operated one. Multi-h ooks systems used for surgical correction of scoliosis are helpful in term of coronal plan correction but no system effectively derotates the spine. S coliotic population experiences significatively more back pain than control group. There is a higher prevalence of negative perception of health but a more positive perception of self in the scoliotic population compared to a control group.