NATURAL-HISTORY OF ADOLESCENT THORACOLUMBAR AND LUMBAR IDIOPATHIC SCOLIOSIS INTO ADULTHOOD

Thirty-four patients with adolescent idiopathic thoracolumbar, lumbar, or lumbar components of double major curves between 20 and 55 degrees were identified. This study group was compared with an age- and sex-m atched control group with regard to back pain, radicular symptoms, and perception of handicap. The objectives of this study were to define t he natural history of moderate-range adolescent idiopathic thoracolumb ar, lumbar, and double major cur?ies with a lumbar component in this r ange. Studies that exclusively examined the natural history of thoraco lumbar and more caudad curves have not been undertaken. Data from othe r related studies is often clouded by various factors. We reviewed the charts and radiographs of 363 patients with idiopathic scoliosis seen between 1935 and 1975 with available original radiographs. Thirty-fou r of 65 patients (52%) answered a questionnaire pertaining to severity of pain, functional abilities, and perceived quality of life. The sam e questionnaire was answered by 31 age- and sex-matched controls for c omparison. The average follow-up was 22 years, and average patient age at current follow-up was 36 years. Curves at skeletal maturity measur ed an average of 35 degrees., On a scale of 1-10 (severe), current low -back pain in the study group was rated a mean of 3.19 versus 1.94 in the control group. Twelve of 34 patients in the study group (35%) repo rted no back pain, versus 21 of 31 (68%) in the control group. Twenty- four percent of the study group had radicular symptoms compared with 1 6% of the control group. None of the 34 study patients and 1 control p atient underwent surgery for back pain. With an average follow-up of 2 2 years, the study group reported handicap scores comparable to those of the control group. The average age of the study patients was only 3 6 years, but it is encouraging that these individuals have continued t o do well for at least 20 years past skeletal maturity.