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February 5, 2003

Sizing Up Scoliosis

Author Affiliations

Author Affiliation: Department of Orthopedics, Johns Hopkins University School of Medicine, Baltimore, Md.

JAMA. 2003;289(5):608-609. doi:10.1001/jama.289.5.608

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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