Idiopathic scoliosis is a structural, lateral curvature of the spine for which no etiology has been established. Chronologically, idiopathic scoliosis can be categorized on the basis of the age of the patient at first identification of the deformity: infantile (birth to two years and eleven months), juvenile (three years to nine years and eleven months), and adolescent (ten years to seventeen years and eleven months). Thus, this article will describe the scoliotic deformities of patients who are at least three years of age but younger than ten years of age when the deformity is first identified. It has been demonstrated that spinal growth is fairly steady during this juvenile period1. For this reason, Dickson and Archer believed that true juvenile-onset scoliosis was rare enough not to warrant a separate category. They proposed a two-group classification that included early onset (five years of age or less) and late onset (six years of age and older) scoliosis2. In addition, patients who receive a diagnosis of scoliosis at five years of age or younger have a much higher chance of having a large curve develop, which may lead to pulmonary complications and cor pulmonale1,3. In this paper, we adhere to the classic age-at-onset definition as described by Dickson and Archer but do not describe adolescent idiopathic scoliosis.
Natural History and Epidemiology
Between 12% and 21% of patients with idiopathic scoliosis can be included in the category of juvenile idiopathic scoliosis4, the gradual transition period between infantile idiopathic scoliosis and adolescent idiopathic scoliosis. This is certainly true with regard to sex predilection: the female-to-male ratio is 1:1 in children between three and six years of age, 2:1 to 4:1 overall in children who are at least three but less than ten years of age5, and 8:1 …
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