Observations on idiopathic scoliosis aetiology and natural history in Jamaica - abstract

ABSTRACT

In 1953, the Orthopaedic Department at the University of the West Indies opened. Over the next five years, careful records were kept of the diagnosis of every patient seen in the Clinics. Amongst the findings was the observation that the idiopathic form of scoliosis appeared to be uncommon. There was a strong impression that the incidence of scoliosis was altering. From the second half of 1956, records of every patient with scoliosis from whatever cause have been kept. Only cases of severity great enough to attend an Orthopaedic Clinic and found to have a curve measuring over 10 degrees have been included. These records show that scoliosis has been an unusual condition from at least 1920 when our earliest case was reported as having developed. The condition continued to be unusal up to 1963. Then the whole position began to change. The records of the dates of presentation of new cases showed that there was a sudden increase after 1960 so that these patients became a major clinical problem. The increase in frequency rose rapidly till 1982. Then began a downturn in the number of cases which have continued. This has been in spite of a continuing annual population increase of 1.5 per cent and a steady 50 per cent of the population remaining under 15 years of age. Over the thirty-two years of this study, the general pattern of idiopathic scoliosis seen elsewhere has been found. In addition to the idiopathic group, there were almost 10 per cent due to some obvious cause. The infantile and juvenile types were seen only seldom. It was found that the idiopathic scoliosis patient was consistently above the average height for her age group and that the normal growth spurt appeared earlier in the idiopathic group than in other children. Thus, in Jamaica, there has been almost an epidemic of idiopathic scoliosis which started around 1963 and began to fall off after 1982. The increase in both the heights of these patients and their metacarpal indices suggests that something may have stimulated growth (AU)