Abstract
On April 6th 2011, before the Annual Meeting of the European Pediatric Orthopaedic Society EPOS in Basel/Switzerland, a comprehensive pre-meeting course covered the manifold aspects of adolescent idiopathic scoliosis (AIS). This issue of the Journal of Children's Orthopaedics unifies the manuscripts of the presenters at that course who were willing to contribute to an updated, concise and easy-to-read summary of the most important aspects of AIS.
This epidemiologically most frequent type of scoliosis during growth remains enigmatic and its idiopathic etiology hitherto prevents other-than-symptomatic treatment of the resulting deformity. The most widely used Lenke classification mirrors the transition from two- to three-dimensional thinking and surgical treatment which has occurred within the last 3 decades. It reflects the pathogenetic and biomechanic principle of relative anterior spinal overgrowth with subsequent flattening of the sagittal profile, side bending and transverse plane deformity. The static and dynamic appreciation of the three-dimensionality is the cornerstone of clinical and imaging diagnostics and the basis of treatment. When it comes to treatment decisions, fundamentals regarding the natural history of curve behaviour, the assessment of the risk of progression, of health related quality of life (HrQoL) parameters (such as pain, self-appearance, function) and the influence of curve size and pattern on vital parameters have to be taken into consideration. For patients with significant growth left and modest 25°–40° curves, full-time rigid bracing is the most widely applied attempt to halt progression. The relatively short 100-year historic course of operative scoliosis treatment summarizes the evolution from complication-prone, uninstrumented in situ fusions to modern sophisticated and safe three-dimensional instrumented curve corrections. The lively debate between proponents of anterior and posterior correction techniques is highlighted by two overview articles.