The natural history of idiopathic scoliosis during growth: a meta-analysis

Objective To provide a meta-analysis of current literature concerning the natural history of idiopathic scoliosis during growth. Design A comprehensive search of MEDLINE, EMBASE, and SCOPUS databases was conducted up to November 2016. Eligible works were prospective or retrospective studies that enrolled patients with infantile (IIS), juvenile (JIS), or adolescent idiopathic scoliosis (AIS), followed up without any treatment from the time of detection. A meta-analysis for proportion was performed. The studies were grouped per diagnosis: IIS, JIS, and AIS. Results Of the 1797 citations screened, we assessed 61 full-text articles and included 13 of these (2301 participants). Three studies included IIS patients (347 participants), five studies included a mixed population of JIS and AIS (1330 participants), and five studies included AIS patients only (624 participants). The random pooled estimated progression rate was 49% (95% CI: 1–97%) for IIS; 49% in a mixed group of patients affected by JIS or AIS (95% CI: 19–79%), and 42% in AIS (95% CI: 11–73%). Conclusions During growth, idiopathic scoliosis tends to progress in a high percentage of cases. The progression rate varies according to the age at diagnosis, with infantile scoliosis being the most unpredictable. There are many confounders, such as age, Risser sign and baseline Cobb angles that were not consistent among studies, making the data very heterogeneous. Address correspondence to: Francesca Di Felice, ISICO (Italian Scientific Spine Institute), Via Bellarmino 13/1, Milan, 20141 +393492682688 ORCID iD 0000-0002-9553-4499 Funding Source: No funding was secured for this study. Financial Disclosure: The authors have no financial relationships relevant to this article to disclose. Conflict of Interest: The authors have no conflicts of interest to disclose. Previous presentation at scientific meetings: SOSORT 2017 Lyon, ISSLS 2017 Athens. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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