The Natural History of Early-onset Scoliosis

Lori A. Karol

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background: Early-onset scoliosis (EOS) is defined as the diagnosis of a spinal deformity before the age of 5 years. It can be divided into idiopathic, neuromuscular/syndromic, and congenital etiologies. Methods: The literature on the natural history of EOS was summarized. Results: The natural history varies with the etiology of EOS. Idiopathic curves may benefit from early serial casting. The natural history of neuromuscular and syndromic scoliosis is highly dependent on the natural history of the underlying disorder. Congenital scoliosis has a variable prognosis depending on the location and extent of the congenital malformations. Conclusions: Treatment of children with EOS is customized to the particular disorder. While lack of treatment has been shown to lead to increased mortality, extensive early definitive fusion may lead to thoracic insufficiency. Delaying definitive surgery and the use of growing instrumentation may provide benefit in maintaining pulmonary health. Clinical Relevance: Potential disturbance of growth must be considered in the treatment of young children with scoliosis.

Original languageEnglish (US)
Pages (from-to)S38-S43
JournalJournal of Pediatric Orthopaedics
Issue number6
StatePublished - Jul 1 2019


  • Mehta cast
  • congenital scoliosis
  • early-onset scoliosis
  • pulmonary function

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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