Adolescent idiopathic scoliosis: is rising growth rate the triggering factor in progression?

The school scoliosis screening programme at Our Lady's Hospital for Sick Children, Dublin, has provided material for an ongoing prospective natural history study of adolescent idiopathic scoliosis. An examination of the clinical course in 339 girls showed that observation of progression of at least 10 degrees, which occurred in 46 girls (13.6%), depended on the timing of diagnosis and related primarily to the child's position on her growth rate curve and her pubertal status, and much less to skeletal maturity as interpreted by iliac crest ossification or bone age. This has implications for the understanding of results in conservative management, screening programmes and natural history.