Idiopathic scoliosis is a curious spinal disorder that is remarkable
for its contrasts. In some patients, scoliosis can be physically evident and
often striking on plain radiographs even to the untrained eye. Yet in other
young patients it is not physically evident or symptomatic, so clinicians
must try to predict the effects far into the future.
The landmark study by Weinstein et al1 in
this issue of THE JOURNAL can help with this prediction. Just as longitudinal
studies of populations in Framingham, Mass,2 and
the Precursors Study in Baltimore, Md,3 have
provided bases of medical understanding of cardiovascular disease, the Iowa
studies of the natural history of musculoskeletal disorders form a cornerstone
of orthopedic treatment.4 The senior authors
have been carefully following these patients for 50 years and have published
several earlier analyses.5,6 This
will likely be the final major report, and it is unlikely that a natural history
study of such length and breadth will be matched.
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