title: Evolution of adolescent idiopathic scoliosis: results of a multicenter study at 20 years' follow-up.
abstract: BACKGROUND
  To date there is no consensus on therapeutic indications in adolescent idiopathic scoliosis (AIS) with curvature between 30° and 60° at the end of growth.
  
  
  OBJECTIVE
  The objective of this study was to assess outcome in patients with moderate AIS.
  
  
  METHODS
  A multicenter retrospective study was conducted. Inclusion criteria were: Cobb angle, 30-60° at end of growth; and follow-up > 20 years. The data collected were angular values in adolescence and at last follow-up, and quality of life scores at follow-up.
  
  
  RESULTS
  A total of 258 patients were enrolled: 100 operated on in adolescence, 116 never operated on, and 42 operated on in adulthood. Mean follow-up was 27.8 years. Cobb angle progression significantly differed between the 3 groups: 3.2° versus 8.8° versus 23.6°, respectively; P < 0.001. In lumbar scoliosis, the risk of progression to ≥ 20° was significantly higher for initial Cobb angle > 35° (OR=4.278, P=0.002). There were no significant differences in quality of life scores.
  
  
  CONCLUSIONS
  Patients operated on in adolescence showed little radiological progression, demonstrating the efficacy of surgical treatment for curvature greater than 50°. Curvature greater than 40° was progressive and may require surgery in adulthood. Lumbar scoliosis showed greater potential progression than thoracic scoliosis in adulthood, requiring fusion as of 35° angulation.
  
  
  METHODS
  IV, retrospective study.
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France. Electronic address: sebastien.pesenti@ap-hm.fr.
authors.forename: S
authors.initials: S
authors.lastname: Pesenti
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: J-L
authors.initials: JL
authors.lastname: Jouve
authors.affiliation: Service d'orthopédie pédiatrique, institut Calot, rue du Docteur-Calot, 62600 Berck-sur-Mer, France.
authors.forename: C
authors.initials: C
authors.lastname: Morin
authors.affiliation: Service d'orthopédie, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Wolff
authors.affiliation: Service d'orthopédie pédiatrique, hôpital des Enfants, 330, avenue de Grande-Bretagne, 31029 Toulouse cedex, France.
authors.forename: J
authors.initials: J
authors.lastname: Sales de Gauzy
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants, 7, quai Moncousu, 44000 Nantes, France.
authors.forename: A
authors.initials: A
authors.lastname: Chalopin
authors.affiliation: Service d'orthopédie pédiatrique, hôpital des Enfants, 330, avenue de Grande-Bretagne, 31029 Toulouse cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Ibnoulkhatib
authors.affiliation: Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: E
authors.initials: E
authors.lastname: Polirsztok
authors.affiliation: Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Walter
authors.affiliation: Service de chirurgie du rachis, hôpitaux universitaires de Strasbourg, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Schuller
authors.affiliation: Service d'orthopédie pédiatrique, hôpital Femme-Mère-Enfants, CHU de Lyon, 59, boulevard Pinel, 69677 Bron, France.
authors.forename: K
authors.initials: K
authors.lastname: Abelin-Genevois
authors.affiliation: Clinique chirurgicale infantile, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: J
authors.initials: J
authors.lastname: Leroux
authors.affiliation: Clinique chirurgicale infantile, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76000 Rouen, France.
authors.forename: J
authors.initials: J
authors.lastname: Lechevallier
authors.affiliation: Service d'orthopédie pédiatrique, hôpital Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Kabaj
authors.affiliation: Service d'orthopédie pédiatrique, hôpital Trousseau, 26, avenue du Dr-Arnold-Netter, 75012 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Mary
authors.affiliation: Service de neurochirurgie, Timone, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
authors.affiliation: Centre du rachis, clinique Saint-Léonard, 18, rue de Bellinière, 49800 Trélazé, France.
authors.forename: H
authors.initials: H
authors.lastname: Parent
authors.affiliation: Service d'orthopédie pédiatrique, hôpital Femme-Mère-Enfants, CHU de Lyon, 59, boulevard Pinel, 69677 Bron, France.
authors.forename: C
authors.initials: C
authors.lastname: Garin
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: K
authors.initials: K
authors.lastname: Bin
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: E
authors.initials: E
authors.lastname: Peltier
authors.affiliation: Service d'orthopédie pédiatrique, hôpital d'Enfants de la Timone, Aix-Marseille université de Marseille, 264, rue Saint-Pierre, 13385 Marseille, France.
authors.forename: B
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Service de chirurgie rachidienne, hôpital Roger-Salengro, rue Émile-Laine, 59037 Lille, France.
authors.forename: D
authors.initials: D
authors.lastname: Chopin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012600:Scoliosis / Q000453:epidemiology* / Q000601:surgery*; D012720:Severity of Illness Index; D013123:Spinal Fusion; D055815:Young Adult
keywords: Adolescent idiopathic scoliosis; Natural history of idiopathic scoliosis; Outcome