Long-term effects of scoliosis
Consequences of untreated scoliosis
AIS occurs in children during their pubertal growth spurt and abnormal skeletal growth is associated with the development and progression of the scoliosis. The risk of progression of deformity is the highest in skeletally immature patients. Thus treatment decisions in AIS are made based on the Cobb angle and risk of progression. With worsening of the spinal deformity, patients may develop future problems such as pain, cardiopulmonary compromise, cosmetic problems and negative psychosocial effects. Lung function is affected by large curve sizes. Some studies showed that Cobb angles of >50° may cause reduced vital capacity and more frequent shortness of breath than smaller curves but this is more significant if the angle reaches 80° or above.
Most long-term follow-up of patients with AIS report similar frequency of back pain as those without scoliosis. In the general population, approximately 50% of adults without scoliosis have an episode of lower back pain in any year and 15% may have pain that lasts for more than 2 weeks in any year. However in a 50 year follow-up study conducted in the US, patients with scoliosis had greater frequency, intensity and duration of chronic back pain. But these patients can continue to do work and everyday activities like persons without scoliosis. Most patients with AIS develop early osteoarthritis on x-rays but this may not correlate with back pain.
No studies have found any correlation between pregnancy and curve progression. Although back pain may occur in up to 35-55% of pregnant women who have AIS, the pain is not disabling and is at the same degree as patients without scoliosis. There are also no increased complication rates or risk of caesarian section.