Treatment of scoliosis

We do not know the etiology of the great majority of cases of structural scoliosis with which we are confronted today, namely, the 80 to 90 per cent classified as "idiopathic." Treatment of these cases, once the lateral curvature has developed, must be directed by one knowledgeable in the pathogenesis of scoliosis, the potentialities of these curves in terms of etiology and degree of maturation of the individual, and an awareness of the various methods of treatment. The basic principles of obtaining correction are distraction and the application of corrective forces to the convex side of the curve, by external or internal fixation. Ironically, while our present-day methods are somewhat more refined and sophisticated, these are the same principles that have been utilized since the fifteenth century. We have in the past fifty years added the innovation of fusion of the vertebral segments involved, to maintain the correction that has been attained. Needless to say, we are striving through basic and clinical research to ascertain the cause of idiopathic scoliosis and, at the same time, evolving better methods of efficient and effective correction, and maintaining correction of these deformities, once they have developed.