Spinal Growth and Development   |    
Natural History of Early Onset Scoliosis
Pedro Fernandes, MD; Stuart L. Weinstein, MD
View Disclosures and Other Information
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
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


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.
Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    W. Virginia - Charleston Area Medical Center
    District of Columbia (DC) - Children's National Medical Center
    New York - Icahn School of Medicine at Mount Sinai
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina