Natural history of adolescent thoracolumbar and lumbar idiopathic scoliosis into adulthood.

Thirty-four patients with adolescent idiopathic thoracolumbar, lumbar, or lumbar components of double major curves between 20 and 55 degrees were identified. This study group was compared with an age- and sex-matched control group with regard to back pain, radicular symptoms, and perception of handicap. The objectives of this study were to define the natural history of moderate-range adolescent idiopathic thoracolumbar, lumbar, and double major curves with a lumbar component in this range. Studies that exclusively examined the natural history of thoracolumbar and more caudad curves have not been undertaken. Data from other related studies is often clouded by various factors. We reviewed the charts and radiographs of 363 patients with idiopathic scoliosis seen between 1935 and 1975 with available original radiographs. Thirty-four of 65 patients (52%) answered a questionnaire pertaining to severity of pain, functional abilities, and perceived quality of life. The same questionnaire was answered by 31 age- and sex-matched controls for comparison. The average follow-up was 22 years, and average patient age at current follow-up was 36 years. Curves at skeletal maturity measured an average of 35 degrees. On a scale of 1-10 (severe), current low-back pain in the study group was rated a mean of 3.19 versus 1.94 in the control group. Twelve of 34 patients in the study group (35%) reported no back pain, versus 21 of 31 (68%) in the control group. Twenty-four percent of the study group had radicular symptoms compared with 16% of the control group. None of the 34 study patients and 1 control patient underwent surgery for back pain. With an average follow-up of 22 years, the study group reported handicap scores comparable to those of the control group. The average age of the study patients was only 36 years, but it is encouraging that these individuals have continued to do well for at least 20 years past skeletal maturity.