While technical outcomes of surgery are well known and show obvious benefits for those with significant deformity, long-term health related outcomes have yet to be precisely documented. The lack of quality, long-term studies of sufficient size hampers our understanding of the mortality and morbidity rates for patients with congenital and idiopathic scoliosis, with and without treatment. Fifty years of follow-up studies of children and adolescents with untreated scoliosis have shown conflicting results, with some studies indicating a higher risk of mortality and respiratory compromise.1^,2

Another study shows compromise only in patients with early reduced lung function and a large curvature.3  Yet another study has shown no differences in untreated childhood scoliosis and a control group.4 Several articles from the 1960s and one recent article report that low back pain does not occur more frequently in untreated scoliosis patients than in the general population4^,5^,6 unless the curvature is greater than 40°.7^,8 It has also been shown that persons treated with surgery rather than bracing for adolescent idiopathic scoliosis have less pain at 10- to 20-year follow-up, although function remains similar.9^,10 The cosmetic/self-image aspect of scoliosis is obvious and important, and often a major factor affecting the lives of individuals with this condition.

• 1. Goldberg CJ, Gillic I, Connaughton O, et al. Respiratory function and cosmesis at maturity in infantile-onset scoliosis. Spine 2003;28:2397-2406.
• 2. Pehrsson K, Larsson S, Oden A, Nachemson A. Long-term follow-up of patients with untreated scoliosis: A study of mortality, causes of death, and symptoms. Spine 1992;17:1091-1096.
• 3. Pehrsson K, Bake B, Larsson S, Nachemson A. Lung function in adult idiopathic scoliosis: A 20-year follow- up. Thorax 1991;46:474-478.
• 4. a. b. Weinstein SL, Dolan LA, Spratt KF, et al. Health and function of patients with untreated idiopathic scoliosis: A 50-year natural history study. JAMA 2003;289:559-567.
• 5. Nachemson A. A long-term follow-up study of non-treated scoliosis. Acta Orthop Scand 1968;39:466-476.
• 6. Nilsonne U, Lundgren KD. Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand 1968;39:456-465.
• 7. Kostuik JP, Bentivoglio J. The incidence of low-back pain in adult scoliosis. Spine 1981;6:268-273.
• 8. Haefeli M, Elfering A, Kilian R, et al. Nonoperative treatment for adolescent idiopathic scoliosis: a 10- to 60-year follow-up with special reference to health-related quality of life. Spine 2006;31:355-366.
• 9. Andersen MO, Christensen SB, Thomsen K. Outcome at 10 years treatment for adolescent idiopathic scoliosis. Spine 2006;31:350-354.
• 10. Danielsson AJ, Romberg K, Nachemson AL. Spinal range of motion, muscle endurance, and back pain and function at least 20 years after fusion or brace treatment for adolescent idiopathic scoliosis: A case-control study. Spine 2006;31:275-283.