Natural history of the mild adolescent idiopathic scoliosis / 中华骨科杂志

ABSTRACT

Objective To investigate the natural history of mild adolescent idiopathic scoliosis in a period of 15 years and search for the risk factors of progress as well as to recommend the modification program of school screening for scoliosis. Methods From a group of 204 patients with adolescent idiopathic scoliosis who were detected from school screening for scoliosis among 20 418 school children in Beijing from May 1985 to January 1986, 90 of the patients were reevaluated 15 years later. The follow-up items of the therapeutic history, physical examination and standing spinal X-ray films were carried out. The late data were compared statistically with the original data at the time of school screening. The final results were divided into four groups: 1)Resolved group with a current curve less than 10 degrees; 2)Reduced group with a current curve more than 10 degrees but reducing less than 5 degrees regarding to the original status; 3)Unchanged group with a current curve more than 10 degrees while progressing less than 5 degrees compared to the original data; 4)Progressed group with a current curve was more than 10 degrees and aggravating more than 5 degrees than the original curve. Results Of 204 patients, 111 patients were followed up, and X-ray films were taken in 90. The follow-up results suggested that 29 cases showed resolved(32.2%), 21 cases reduced (23.3%), 30 cases unchanged (33.3%) and 10 cases progressed (11.1%). In 10 cases of progressed group, there were 8 females and 2 males, furthermore, 6 patients were found with the cobbs angle of curve between 10 and 19 degrees and 4 patient with the cobbs angle of curve more than 20 degrees when school screening. The curve pattern of the 10 progressed patients consisted of double thoracic curves in 2, double thoracic and lumbar curves in 2, right thoracic curve in 3, thoraco-lumbar curve in 2 and lumbar curve in 1. Conclusion Most of cases with less than 20 degrees curve are of no progress. The high risks of progress are as followed: curve more than 20 degrees, female, double thoracic curve, double thoracolumbar curve, right thoracic scoliosis and top vertebral rotation more than grade Ⅱ. The school screening for scoliosis should be carried out by school medical team who were trained by orthopaedists. The specialists should reexamine the suspected children and monitor the patients with high risk of progress.