What are the consequences of untreated adolescent idiopathic scoliosis

Natural history studies of untreated adolescent idiopathic scoliosis in adult patients focus on:

• Mortality rate. The mortality rate of untreated adult patients with adolescent idiopathic scoliosis is comparable with that of the general population. Patients with untreated adolescent idiopathic scoliosis do not typically develop respiratory failure and premature death. Patients with adolescent idiopathic scoliosis must be distinguished from patients with early-onset scoliosis (before age 5) who develop severe curves (>90°). Patients with early-onset scoliosis may develop cor pulmonale and right ventricular failure, resulting in premature death

• Pulmonary and cardiac function. Marked limitation of forced vital capacity does not occur until thoracic curves approach 90° in the absence of marked hypokyphosis. Only in thoracic curve patterns is there a direct correlation between curve magnitude and negative effects on pulmonary function

• Back pain. The incidence of back pain in adult scoliosis patients is comparable with the general population. Patients with large lumbar curves report an increased incidence of low back pain, particularly if a significant lateral translation develops

• Self-image. Spinal deformity and its negative effect on self-image remain a significant issue for many adult scolio-sis patients. These issues are frequently the reason adult patients seek treatment for idiopathic scoliosis

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