0
May 26, 1993, Vol 269, No. 20 >
ARTICLE | May 26, 1993

Screening for Adolescent Idiopathic Scoliosis: Title and subTitle BreakReview Article FREE

Harold C. Sox, Jr, MD; Donald M. Berwick, MD, MPP; Alfred O. Berg, MD, MPH; Paul S. Frame, MD; Dennis G. Fryback, PhD; David A. Grimes, MD; Robert S. Lawrence, MD; Robert B. Wallace, MD; A. Eugene Washington, MD, MSc; Modena E. H. Wilson, MD, MPH; Steven H. Woolf, MD, MPH
[+] Author Affiliations

Reprint requests to the Office of Disease Prevention and Health Promotion, US Public Health Service, 330 C St SW, Room 2132, Switzer Bldg, Washington, DC 20201 (Steven H. Woolf, MD, MPH).


JAMA. 1993;269(20):2667-2672. doi:10.1001/jama.1993.03500200081038
Text Size: A A A
Published online
Article
References

THE SCOLIOSIS Research Society defines scoliosis as a lateral spinal curve of 11° or greater. An estimated 500 000 adults in the United States have scoliosis.1 Idiopathic scoliosis accounts for about 65% of cases of structural scoliosis2,3 (curves caused by spinal column disorders vs other conditions, such as limb-length inequality), and a large proportion of these cases develop during adolescence. A lateral spinal curve of 11° or greater is present in about 2% to 3% of adolescents at the end of their growth period. Curves greater than 20° occur in less than 0.5% of adolescents.4

Scoliosis can progress undetected as the size of the spinal curve increases. The progression is generally painless and produces no symptoms. Curves may be unnoticed by parents or other adults because the deviations are subtle. Health professionals may also fail to detect the disorder because an examination of the spine may not

REFERENCES

1 +
American Association of Orthopaedic Surgeons Committee on Communications and Publications.  A statement regarding school screening programs for the early detection of scoliosis. Am Acad Orthop Surg Bull . 1984;;32( (1) ):27.
2 +
Berwick DM.  Scoliosis screening. Pediatr Rev . 1984;;5:238-247.
3 +
Riseborough EJ, Herndon JH. Scoliosis and Other Deformities of the Axial Skeleton . Boston, Mass: Little, Brown & Co; 1975;:22.
4 +
Renshaw TS.  Screening school children for scoliosis. Clin Orthop . 1988;;229:26-33.
5 +
Scoliosis Research Society. Scoliosis: A Handbook for Patients . Park Ridge, Ill: Scoliosis Research Society; 1986;.
6 +
US Preventive Services Task Force.  Screening for adolescent idiopathic scoliosis: policy statement. JAMA . 1993;;269:2664-2666.
7 +
Bengtsson G, Fallstrom K, Jansson B, Nachemson A.  A psychological and psychiatric investigation of the adjustment of female scoliosis patients. Acta Psychiatr Scand . 1974;;50:50-59.
8 +
Weinstein SL.  Adolescent idiopathic scoliosis: prevalence and natural history. Instr Course Lect . 1989;;38:115-128.
9 +
Weinstein SL, Zavala DC, Ponseti IV.  Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am . 1981;; 63:702-712.
10 +
Nilsonne U, Lundgren KD.  Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand . 1968;;39:456-465.
11 +
Nachemson A.  A long-term follow-up study of non-treated scoliosis. Acta Orthop Scand . 1968;;39: 466-476.
12 +
Kolind-Sorensen V.  A follow-up study of patients with idiopathic scoliosis. Acta Orthop Scand . 1973;;44:98.
13 +
Fowles JV, Drummond DS, L'Ecuyer S, Roy L, Kassab MT.  Untreated scoliosis in the adult. Clin Orthop . 1978;;134:212-217.
14 +
Davies G, Reid L.  Effect of scoliosis on growth of alveoli and pulmonary arteries and on the right ventricle. Arch Dis Child . 1971;;46:623.
15 +
Branthwaite MA.  Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest . 1986;;80:360-369.
16 +
Smyth RJ, Chapman KR, Wright TA, Crawford JS, Rebuck AS.  Ventilatory patterns during hypoxia, hypercapnia, and exercise in adolescents with mild scoliosis. Pediatrics . 1986;;77:692-697.
17 +
Dickson RA.  Conservative treatment for idiopathic scoliosis. J Bone Joint Surg Br . 1985;;67:176-181.
18 +
Nachemson A, Lonstein JE, Weinstein SL. Report of the Prevalence and Natural History Committee . Park Ridge, Ill: Natural History Committee of Scoliosis Research Society; 1982;.
19 +
Lonstein JE, Carlson MC.  Prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am . 1984;;66:1061-1071.
20 +
Bunnell WP.  The natural history of idiopathic scoliosis before skeletal maturity. Spine . 1986;;11: 773-776.
21 +
Willner S, Uden A.  A prospective prevalence study of scoliosis in southern Sweden. Acta Orthop Scand . 1982;;53:233-237.
22 +
Rogala E, Drummond D, Gurr J.  Scoliosis: incidence and natural history. J Bone Joint Surg Am . 1978;;60:173. Abstract.
23 +
Gore DG, Passehl R, Sepic S, Dalton A.  Scoliosis screening: results of a community project. Pediatrics . 1981;;67:196-200.
24 +
Lonstein JE.  Natural history and school screening for scoliosis. Orthop Clin North Am . 1988;;19: 227-237.
25 +
Renshaw TS.  Screening school children for scoliosis. Clin Orthop . 1988;;229:26-33.
26 +
Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH.  Measurement of the Cobb angle on radiographs of patients who have scoliosis: evaluation of intrinsic error. J Bone Joint Surg Am . 1990;;72: 320-327.
27 +
Morais T, Bernier M, Turcotte F.  Age- and sex-specific prevalence of scoliosis and the value of school screening programs. Am J Public Health . 1985;;75:1377-1380.
28 +
Viviani GR, Budgell L, Dok C, Tugwell P.  Assessment of accuracy of the scoliosis school screening examination. Am J Public Health . 1984;;74:497-498.
29 +
Chan A, Moller J, Vimpani G, Paterson D, Southwood R, Sutherland A.  The case for scoliosis screening in Australian adolescents. Med J Aust . 1986;; 145:379-383.
30 +
Bunnell WP.  An objective criterion for scoliosis screening. J Bone Joint Surg Am . 1984;;66:1381-1387.
31 +
Amendt LE, Ause-Ellias KL, Eybers JL, Wadsworth CT, Nielsen DH, Weinstein SL.  Validity and reliability testing of the scoliometer. Phys Ther . 1990;;70:108-117.
32 +
Laulund T, Sojbjerg J, Horlyck E.  Moiré topography in school screening for structural scoliosis. Acta Orthop Scand . 1982;;53:765-768.
33 +
Berwick DM.  Scoliosis screening: a pause in the chase. Am J Public Health . 1985;;75:1373-1374.
34 +
Focarile FA, Bonaldi A, Giarolo MA, Ferrari U, Zilioli E, Ottaviani C.  Effectiveness of nonsurgical treatment for idiopathic scoliosis: overview of available evidence. Spine . 1991;;16:395-401.
35 +
Torell G, Nordwall A, Nachemson A.  The changing pattern of scoliosis treatment due to effective screening. J Bone Joint Surg Am . 1981;;63:337-341.
36 +
Lonstein JE, Bjorklund S, Wanninger MH, Nelson RP.  Voluntary school screening for scoliosis in Minnesota. J Bone Joint Surg Am . 1982;;64:481-488.
37 +
Ferris B, Edgar M, Leyshon A.  Screening for scoliosis. Acta Orthop Scand . 1988;;59:417-418.
38 +
Montgomery F, Willner S.  The natural history of idiopathic scoliosis: a study of the incidence of treatment. Spine . 1988;;13:401-404.
39 +
Jonasson-Rajala E, Josefsson E, Lundberg B, Nilsson H.  Boston thoracic brace in the treatment of idiopathic scoliosis: initial correction. Clin Orthop . 1984;;183:37-41.
40 +
Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME.  The Boston bracing system for idiopathic scoliosis: follow-up results in 295 patients. Spine . 1986;; 11:792-801.
41 +
Bassett GS, Bunnell WP, MacEwen GD.  Treatment of idiopathic scoliosis with the Wilmington brace. J Bone Joint Surg Am . 1986;;68:602-605.
42 +
Mellencamp DD, Blount WP, Anderson AJ.  Milwaukee brace treatment of idiopathic scoliosis: late results. Clin Orthop . 1977;;126:47-57.
43 +
Carr W, Moe J, Winter R, Lonstein J.  Treatment of idiopathic scoliosis in the Milwaukee brace. J Bone Joint Surg Am . 1980;;62:599-612.
44 +
Miller JAA, Nachemson AL, Schultz AB.  Effectiveness of braces in mild idiopathic scoliosis. Spine . 1984;;9:632-635.
45 +
Kehl DK, Morrissy RT.  Brace treatment in adolescent idiopathic scoliosis: an update on concepts and technique. Clin Orthop . 1988;;229:34-43.
46 +
Weisz I, Jefferson RJ, Carr AJ, et al.  Back shape in brace treatment of idiopathic scoliosis. Clin Orthop . 1989;;240:157-162.
47 +
Wynne EJ.  Scoliosis: to screen or not to screen. Can J Public Health . 1984;;75:277-280.
48 +
DiRaimondo CV, Green NE.  Brace-wear compliance in patients with adolescent idiopathic scoliosis. J Pediatr Orthop . 1988;;8:143-146.
49 +
Gratz RR, Papalia-Finlay D.  Psychosocial adaptation to wearing the Milwaukee brace for scoliosis. J Adolesc Health Care . 1984;;5:237-242.
50 +
Francis EE.  Lateral electrical surface stimulation treatment for scoliosis. Pediatr Nurs . 1987;; 13:157-160.
51 +
Kahanovitz N, Snow B, Pinter I.  The comparative results of psychologic testing in scoliosis patients treated with electrical stimulation or bracing. Spine . 1984;;9:442-444.
52 +
Kahanovitz N, Weiser S.  Lateral electrical surface stimulation (LESS) compliance in adolescent female scoliosis patients. Spine . 1986;;11:753-755.
53 +
Axelgaard J, Brown JC.  Lateral electrical surface stimulation for the treatment of progressive idiopathic scoliosis. Spine . 1983;;8:242-260.
54 +
McCollough NC.  Nonoperative treatment of idiopathic scoliosis using surface electrical stimulation. Spine . 1986;;11:802-804.
55 +
Bradford DS, Tanguy A, Vanselow J.  Surface electrical stimulation in the treatment of idiopathic scoliosis: preliminary results in 30 patients. Spine . 1983;;8:757-764.
56 +
Sullivan JA, Davidson R, Renshaw TS, Emans JB, Johnston C, Sussman M.  Further evaluation of the Scolitron treatment of idiopathic adolescent scoliosis. Spine . 1986;;11:903-906.
57 +
O'Donnell CS, Bunnell WP, Betz RR, Bowen JR, Tipping CR.  Electrical stimulation in the treatment of idiopathic scoliosis. Clin Orthop . 1988;;229: 107-113.
58 +
Farady JA.  Current principles in the nonoperative management of structural adolescent idiopathic scoliosis. Phys Ther. 1983;;63:512-523.
59 +
Stone B, Beekman C, Hall V, Guess V, Brooks HL.  The effect of an exercise program on change in curve in adolescents with minimal idiopathic scoliosis. Phys Ther . 1979;;59:759-763.
60 +
Dickson RA, Leatherman KD.  Cotrel traction, exercises, casting in the treatment of idiopathic scoliosis: a pilot study and prospective randomized controlled clinical trial. Acta Orthop Scand . 1978;; 49:46-48.
61 +
Weiss HR.  The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis. Spine . 1991;;16:88-93.
62 +
Miyasaki RA.  Immediate influence of the thoracic flexion exercise on vertebral position in Milwaukee brace wearers. Phys Ther . 1980;;60:1005-1009.
63 +
Kostuik JP.  Operative treatment of idiopathic scoliosis. J Bone Joint Surg Am . 1990;;72:1108-1113.
64 +
Renshaw TS.  The role of Harrington instrumentation and posterior spine fusion in the management of adolescent idiopathic scoliosis. Orthop Clin North Am . 1988;;19:257-267.
65 +
Akbarnia BA.  Selection of methodology in surgical treatment of adolescent idiopathic scoliosis. Orthop Clin North Am . 1988;;19:319-329.
66 +
La Grone MO.  Loss of lumbar lordosis: a complication of spinal fusion for scoliosis. Orthop Clin North Am . 1988;;19:383-393.
67 +
Thompson JP, Transfeldt EE, Bradford DS, Ogilvie JW, Boachie-Adjei O.  Decompensation after Cotrel-Dubousset instrumentation of idiopathic scoliosis. Spine . 1990;;15:927-931.
68 +
Winter RB, Lonstein JE, VandenBrink K, et al.  The surgical treatment of thoracic adolescent idiopathic scoliosis with a Harrington rod and sublaminar wires. Orthop Trans . 1987;;11:89.
69 +
Christodoulou AG, Prince HG, Webb JK, et al.  Adolescent idiopathic scoliosis. J Bone Joint Surg Br . 1987;;69:13-16.
70 +
Shufflebarger HL, Crawford AH.  Is Cotrel-Dubousset instrumentation the treatment of choice for idiopathic scoliosis in the adolescent who has an operative thoracic curve? Orthopedics . 1988;;11:1579-1588.
71 +
Moskowitz A, Moe JH, Winter RB, Binner H.  Long-term follow-up of scoliosis fusion. J Bone Joint Surg Am . 1980;;62:364-376.
72 +
Edgar MA, Mehta MH.  Long-term follow-up of fused and unfused idiopathic scoliosis. J Bone Joint Surg Br . 1988;;70:712-716.
73 +
Dickson JH, Erwin WD, Rossi D.  Harrington instrumentation and arthrodesis for idiopathic scoliosis: a twenty-one year follow-up . J Bone Joint Surg Am . 1990;;72:678-683.
74 +
Butler PF, Thomas AW, Wollerton MA, Thompson WE, Rachlin JA. Patient Exposure Reduction During Scoliosis Radiography . Rockville, Md: Food and Drug Administration; 1985;. HHS publication FDA 85-8251.
75 +
Fallstrom K, Cochran T, Nachemson A.  Long-term effects on personality development in patients with adolescent idiopathic scoliosis: influence of type of treatment. Spine . 1986;;11:756-758.
76 +
Montgomery F, Persson U, Benoni G, Willner S, Lindgren B.  Screening for scoliosis: a cost-effectiveness analysis. Spine . 1990;;15:67-70.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
American Association of Orthopaedic Surgeons Committee on Communications and Publications.  A statement regarding school screening programs for the early detection of scoliosis. Am Acad Orthop Surg Bull . 1984;;32( (1) ):27.
2 +
Berwick DM.  Scoliosis screening. Pediatr Rev . 1984;;5:238-247.
3 +
Riseborough EJ, Herndon JH. Scoliosis and Other Deformities of the Axial Skeleton . Boston, Mass: Little, Brown & Co; 1975;:22.
4 +
Renshaw TS.  Screening school children for scoliosis. Clin Orthop . 1988;;229:26-33.
5 +
Scoliosis Research Society. Scoliosis: A Handbook for Patients . Park Ridge, Ill: Scoliosis Research Society; 1986;.
6 +
US Preventive Services Task Force.  Screening for adolescent idiopathic scoliosis: policy statement. JAMA . 1993;;269:2664-2666.
7 +
Bengtsson G, Fallstrom K, Jansson B, Nachemson A.  A psychological and psychiatric investigation of the adjustment of female scoliosis patients. Acta Psychiatr Scand . 1974;;50:50-59.
8 +
Weinstein SL.  Adolescent idiopathic scoliosis: prevalence and natural history. Instr Course Lect . 1989;;38:115-128.
9 +
Weinstein SL, Zavala DC, Ponseti IV.  Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am . 1981;; 63:702-712.
10 +
Nilsonne U, Lundgren KD.  Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand . 1968;;39:456-465.
11 +
Nachemson A.  A long-term follow-up study of non-treated scoliosis. Acta Orthop Scand . 1968;;39: 466-476.
12 +
Kolind-Sorensen V.  A follow-up study of patients with idiopathic scoliosis. Acta Orthop Scand . 1973;;44:98.
13 +
Fowles JV, Drummond DS, L'Ecuyer S, Roy L, Kassab MT.  Untreated scoliosis in the adult. Clin Orthop . 1978;;134:212-217.
14 +
Davies G, Reid L.  Effect of scoliosis on growth of alveoli and pulmonary arteries and on the right ventricle. Arch Dis Child . 1971;;46:623.
15 +
Branthwaite MA.  Cardiorespiratory consequences of unfused idiopathic scoliosis. Br J Dis Chest . 1986;;80:360-369.
16 +
Smyth RJ, Chapman KR, Wright TA, Crawford JS, Rebuck AS.  Ventilatory patterns during hypoxia, hypercapnia, and exercise in adolescents with mild scoliosis. Pediatrics . 1986;;77:692-697.
17 +
Dickson RA.  Conservative treatment for idiopathic scoliosis. J Bone Joint Surg Br . 1985;;67:176-181.
18 +
Nachemson A, Lonstein JE, Weinstein SL. Report of the Prevalence and Natural History Committee . Park Ridge, Ill: Natural History Committee of Scoliosis Research Society; 1982;.
19 +
Lonstein JE, Carlson MC.  Prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am . 1984;;66:1061-1071.
20 +
Bunnell WP.  The natural history of idiopathic scoliosis before skeletal maturity. Spine . 1986;;11: 773-776.
21 +
Willner S, Uden A.  A prospective prevalence study of scoliosis in southern Sweden. Acta Orthop Scand . 1982;;53:233-237.
22 +
Rogala E, Drummond D, Gurr J.  Scoliosis: incidence and natural history. J Bone Joint Surg Am . 1978;;60:173. Abstract.
23 +
Gore DG, Passehl R, Sepic S, Dalton A.  Scoliosis screening: results of a community project. Pediatrics . 1981;;67:196-200.
24 +
Lonstein JE.  Natural history and school screening for scoliosis. Orthop Clin North Am . 1988;;19: 227-237.
25 +
Renshaw TS.  Screening school children for scoliosis. Clin Orthop . 1988;;229:26-33.
26 +
Morrissy RT, Goldsmith GS, Hall EC, Kehl D, Cowie GH.  Measurement of the Cobb angle on radiographs of patients who have scoliosis: evaluation of intrinsic error. J Bone Joint Surg Am . 1990;;72: 320-327.
27 +
Morais T, Bernier M, Turcotte F.  Age- and sex-specific prevalence of scoliosis and the value of school screening programs. Am J Public Health . 1985;;75:1377-1380.
28 +
Viviani GR, Budgell L, Dok C, Tugwell P.  Assessment of accuracy of the scoliosis school screening examination. Am J Public Health . 1984;;74:497-498.
29 +
Chan A, Moller J, Vimpani G, Paterson D, Southwood R, Sutherland A.  The case for scoliosis screening in Australian adolescents. Med J Aust . 1986;; 145:379-383.
30 +
Bunnell WP.  An objective criterion for scoliosis screening. J Bone Joint Surg Am . 1984;;66:1381-1387.
31 +
Amendt LE, Ause-Ellias KL, Eybers JL, Wadsworth CT, Nielsen DH, Weinstein SL.  Validity and reliability testing of the scoliometer. Phys Ther . 1990;;70:108-117.
32 +
Laulund T, Sojbjerg J, Horlyck E.  Moiré topography in school screening for structural scoliosis. Acta Orthop Scand . 1982;;53:765-768.
33 +
Berwick DM.  Scoliosis screening: a pause in the chase. Am J Public Health . 1985;;75:1373-1374.
34 +
Focarile FA, Bonaldi A, Giarolo MA, Ferrari U, Zilioli E, Ottaviani C.  Effectiveness of nonsurgical treatment for idiopathic scoliosis: overview of available evidence. Spine . 1991;;16:395-401.
35 +
Torell G, Nordwall A, Nachemson A.  The changing pattern of scoliosis treatment due to effective screening. J Bone Joint Surg Am . 1981;;63:337-341.
36 +
Lonstein JE, Bjorklund S, Wanninger MH, Nelson RP.  Voluntary school screening for scoliosis in Minnesota. J Bone Joint Surg Am . 1982;;64:481-488.
37 +
Ferris B, Edgar M, Leyshon A.  Screening for scoliosis. Acta Orthop Scand . 1988;;59:417-418.
38 +
Montgomery F, Willner S.  The natural history of idiopathic scoliosis: a study of the incidence of treatment. Spine . 1988;;13:401-404.
39 +
Jonasson-Rajala E, Josefsson E, Lundberg B, Nilsson H.  Boston thoracic brace in the treatment of idiopathic scoliosis: initial correction. Clin Orthop . 1984;;183:37-41.
40 +
Emans JB, Kaelin A, Bancel P, Hall JE, Miller ME.  The Boston bracing system for idiopathic scoliosis: follow-up results in 295 patients. Spine . 1986;; 11:792-801.
41 +
Bassett GS, Bunnell WP, MacEwen GD.  Treatment of idiopathic scoliosis with the Wilmington brace. J Bone Joint Surg Am . 1986;;68:602-605.
42 +
Mellencamp DD, Blount WP, Anderson AJ.  Milwaukee brace treatment of idiopathic scoliosis: late results. Clin Orthop . 1977;;126:47-57.
43 +
Carr W, Moe J, Winter R, Lonstein J.  Treatment of idiopathic scoliosis in the Milwaukee brace. J Bone Joint Surg Am . 1980;;62:599-612.
44 +
Miller JAA, Nachemson AL, Schultz AB.  Effectiveness of braces in mild idiopathic scoliosis. Spine . 1984;;9:632-635.
45 +
Kehl DK, Morrissy RT.  Brace treatment in adolescent idiopathic scoliosis: an update on concepts and technique. Clin Orthop . 1988;;229:34-43.
46 +
Weisz I, Jefferson RJ, Carr AJ, et al.  Back shape in brace treatment of idiopathic scoliosis. Clin Orthop . 1989;;240:157-162.
47 +
Wynne EJ.  Scoliosis: to screen or not to screen. Can J Public Health . 1984;;75:277-280.
48 +
DiRaimondo CV, Green NE.  Brace-wear compliance in patients with adolescent idiopathic scoliosis. J Pediatr Orthop . 1988;;8:143-146.
49 +
Gratz RR, Papalia-Finlay D.  Psychosocial adaptation to wearing the Milwaukee brace for scoliosis. J Adolesc Health Care . 1984;;5:237-242.
50 +
Francis EE.  Lateral electrical surface stimulation treatment for scoliosis. Pediatr Nurs . 1987;; 13:157-160.
51 +
Kahanovitz N, Snow B, Pinter I.  The comparative results of psychologic testing in scoliosis patients treated with electrical stimulation or bracing. Spine . 1984;;9:442-444.
52 +
Kahanovitz N, Weiser S.  Lateral electrical surface stimulation (LESS) compliance in adolescent female scoliosis patients. Spine . 1986;;11:753-755.
53 +
Axelgaard J, Brown JC.  Lateral electrical surface stimulation for the treatment of progressive idiopathic scoliosis. Spine . 1983;;8:242-260.
54 +
McCollough NC.  Nonoperative treatment of idiopathic scoliosis using surface electrical stimulation. Spine . 1986;;11:802-804.
55 +
Bradford DS, Tanguy A, Vanselow J.  Surface electrical stimulation in the treatment of idiopathic scoliosis: preliminary results in 30 patients. Spine . 1983;;8:757-764.
56 +
Sullivan JA, Davidson R, Renshaw TS, Emans JB, Johnston C, Sussman M.  Further evaluation of the Scolitron treatment of idiopathic adolescent scoliosis. Spine . 1986;;11:903-906.
57 +
O'Donnell CS, Bunnell WP, Betz RR, Bowen JR, Tipping CR.  Electrical stimulation in the treatment of idiopathic scoliosis. Clin Orthop . 1988;;229: 107-113.
58 +
Farady JA.  Current principles in the nonoperative management of structural adolescent idiopathic scoliosis. Phys Ther. 1983;;63:512-523.
59 +
Stone B, Beekman C, Hall V, Guess V, Brooks HL.  The effect of an exercise program on change in curve in adolescents with minimal idiopathic scoliosis. Phys Ther . 1979;;59:759-763.
60 +
Dickson RA, Leatherman KD.  Cotrel traction, exercises, casting in the treatment of idiopathic scoliosis: a pilot study and prospective randomized controlled clinical trial. Acta Orthop Scand . 1978;; 49:46-48.
61 +
Weiss HR.  The effect of an exercise program on vital capacity and rib mobility in patients with idiopathic scoliosis. Spine . 1991;;16:88-93.
62 +
Miyasaki RA.  Immediate influence of the thoracic flexion exercise on vertebral position in Milwaukee brace wearers. Phys Ther . 1980;;60:1005-1009.
63 +
Kostuik JP.  Operative treatment of idiopathic scoliosis. J Bone Joint Surg Am . 1990;;72:1108-1113.
64 +
Renshaw TS.  The role of Harrington instrumentation and posterior spine fusion in the management of adolescent idiopathic scoliosis. Orthop Clin North Am . 1988;;19:257-267.
65 +
Akbarnia BA.  Selection of methodology in surgical treatment of adolescent idiopathic scoliosis. Orthop Clin North Am . 1988;;19:319-329.
66 +
La Grone MO.  Loss of lumbar lordosis: a complication of spinal fusion for scoliosis. Orthop Clin North Am . 1988;;19:383-393.
67 +
Thompson JP, Transfeldt EE, Bradford DS, Ogilvie JW, Boachie-Adjei O.  Decompensation after Cotrel-Dubousset instrumentation of idiopathic scoliosis. Spine . 1990;;15:927-931.
68 +
Winter RB, Lonstein JE, VandenBrink K, et al.  The surgical treatment of thoracic adolescent idiopathic scoliosis with a Harrington rod and sublaminar wires. Orthop Trans . 1987;;11:89.
69 +
Christodoulou AG, Prince HG, Webb JK, et al.  Adolescent idiopathic scoliosis. J Bone Joint Surg Br . 1987;;69:13-16.
70 +
Shufflebarger HL, Crawford AH.  Is Cotrel-Dubousset instrumentation the treatment of choice for idiopathic scoliosis in the adolescent who has an operative thoracic curve? Orthopedics . 1988;;11:1579-1588.
71 +
Moskowitz A, Moe JH, Winter RB, Binner H.  Long-term follow-up of scoliosis fusion. J Bone Joint Surg Am . 1980;;62:364-376.
72 +
Edgar MA, Mehta MH.  Long-term follow-up of fused and unfused idiopathic scoliosis. J Bone Joint Surg Br . 1988;;70:712-716.
73 +
Dickson JH, Erwin WD, Rossi D.  Harrington instrumentation and arthrodesis for idiopathic scoliosis: a twenty-one year follow-up . J Bone Joint Surg Am . 1990;;72:678-683.
74 +
Butler PF, Thomas AW, Wollerton MA, Thompson WE, Rachlin JA. Patient Exposure Reduction During Scoliosis Radiography . Rockville, Md: Food and Drug Administration; 1985;. HHS publication FDA 85-8251.
75 +
Fallstrom K, Cochran T, Nachemson A.  Long-term effects on personality development in patients with adolescent idiopathic scoliosis: influence of type of treatment. Spine . 1986;;11:756-758.
76 +
Montgomery F, Persson U, Benoni G, Willner S, Lindgren B.  Screening for scoliosis: a cost-effectiveness analysis. Spine . 1990;;15:67-70.

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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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