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Spinal Growth and Development   |    
Natural History of Early Onset Scoliosis
Pedro Fernandes, MD; Stuart L. Weinstein, MD
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Feb 01;89(suppl 1):21-33. doi: 10.2106/JBJS.F.00754
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Extract

Idiopathic scoliosis is a structural, lateral curvature of the spine of unknown etiology that can occur in otherwise normal children and adolescents. It is a condition that is affected by growth during the first two decades of life. Harrenstein, in 19361, coined the term infantile idiopathic scoliosis. He related it to rickets, stating that the curve responded well to bracing. In 1951, James2, in his preliminary report on infantile idiopathic scoliosis, described the cases of thirty-three infants who were three years of age or less and had a structural left thoracic curve with no apparent etiology. Most of the infants were boys. The scoliosis in these infants occasionally resolved, but when it did progress it tended to progress to a very serious deformity. Later, in 1954, he classified idiopathic scoliosis into three groups on the basis of age of onset: infantile scoliosis with onset up to three years of age, juvenile scoliosis with onset from four to eight years of age, and adolescent scoliosis from ten years of age until the end of growth, with no reference to the ages between eight and ten years3. This classification was eventually related to prognosis and outcome, and was soon integrated with the previously described classification of Ponseti and Friedman, defining different curve patterns according to the location of the apical vertebra4. According to James, the earlier the onset, the worse would be the final curvature and, hence, the prognosis3. The accuracy of his observation is well recognized in clinical practice and in the literature, as infantile and juvenile progressive curves are among the most challenging problems in spinal deformity care and have possible implications for the development of pulmonary parenchyma and, secondarily, a decreased life span5.
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