Idiopathic Scoliosis in Adolescents

Idiopathic scoliosis affects 2% of adolescents. In adolescents with an immature skeleton, bracing is commonly recommended if there is curve progression to 25 to 45 degrees. A randomized trial comparing bracing with watchful waiting is under way. Foreword This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage A 12-year-old girl presents with her parents after a positive school screening for scoliosis. Physical examination reveals shoulder and torso asymmetry with trunk imbalance (i.e., shift from the midline). Neurologic and skin examinations are normal. How should the patient be evaluated and treated? The Clinical Problem Scoliosis is the most common deformity of the spine. Although the term “scoliosis” may be used by some clinicians to describe any curvature of the spine noted on clinical examination or incidental finding on radiography, the term should be reserved for a precise condition. Scoliosis is defined as a lateral curvature of the . . .