A.This is commonest type of idiopathic scoliosis. 80% of the patients are females. The presentation is usually subtle and is unnoticed for a long time. Asymmetry of the shoulders, poor fitting of clothes, a rib hump, a prominent shoulder blade draw the attention of the parents. Severe untreated scoliosis produces physiologic cardiopulmonary impairment and unacceptable cosmetic appearance. The natural history varies with the severity of scoliosis. Curves more than 30 degrees progress. Progression occurs commonly during the growth spurt. Curves greater than 50-60 degrees are known to progress even after maturity.

Mild curves (less than 20 degrees) need to be observed for progression. Moderate curves are treated by bracing, the objectives of treatment are :

Curves more than 45 degrees cannot be treated by bracing and have to be treated by surgery.

The principle of surgery is to correct the deformity till the spine is compensated and then fusion of the spine. Instrumentation( e.g. Harrington rod) is used to achieve correction and maintain it till fusion occurs . If instrumentation is used in children with a major growth spurt remaining, the patient may require a staged surgical correction.

Patient pre surgery

Patient post surgery