Advances in idiopathic scoliosis in children and adolescents

The understanding of idiopathic scoliosis continues to evolve. At some time in the foreseeable future the term will be oxymoronic. It may eventuate, based on a series of laboratory and genetic tests, that there will be three groups: One in which the curve will never be of significance and regular follow-up is unnecessary. A second group with predictable response to a brace. A third group in which spine fusion is an inevitability. This latter group should be allowed to enjoy childhood and early adolescence unfettered by treatment until such time as surgery is necessary. Until then, efforts must be directed toward early detection, comprehensive evaluation, and best efforts at preventing progression of the curve. To this end, a referral to an orthopedic surgeon for suspected scoliosis never is disparaged.