Long-term outcomes of adolescent idiopathic scoliosis: Natural history of untreated, braced, surgically treated patients in adult life

Table 1 Long-term outcomes of untreated adolescent idiopathic scoliosis

Ref.	Type of study	Sample size and follow-up	Curve range (°)	Outcomes	Findings
Weinstein et al[12], 2003	Prospective longitudinal cohort study	117 patients, 50-year follow-up	Mean 60°	Function, pain, HRQoL	Most patients led normal lives with only mild functional limitation. Back pain common but not disabling
Danielsson et al[6], 2010	Retrospective comparative cohort study	109 patients, approximately 22 years	> 45° (untreated vs braced)	HRQoL, pain, self-image	No significant HRQoL difference between braced and untreated patients
Farshad et al[19], 2022	Retrospective cohort study	64 patients, 42-year follow-up	Mean progression approximately 20°	Curve progression, PROMs	Minimal difference in function between observed and braced patients
Brandwijk et al[20], 2023	Cross-sectional long-term follow-up study	60 patients, 30-year follow-up	> 45°	ODI, Short-Form 36	79% minimal disability; pain increased but not clinically disabling
Ascani et al[21], 1986	Retrospective longitudinal cohort study	88 patients, 33 years	30°-80°	Curve progression, disability	Larger curves progressed more, but retained independence and functionality
Ohashi et al[18], 2018	Retrospective longitudinal cohort study	54 patients, 25-year follow-up	Thoracolumbar/Lumbar	Back pain, curve progression	Moderate increase in back pain with progressive curve
Hassan and Bjerkreim[16], 1983	Retrospective cohort study	84 patients, 30-year follow-up	60°-80°	Curve progression rate	Rapid curve progression in adolescence (approximately 3°/year), slowed in adulthood (approximately 1°/year)
Pehrsson et al[26], 1992	Retrospective cohort study	130 patients, 39-year follow-up	Mean 70°	Mortality, pulmonary function	No excess mortality in idiopathic scoliosis; pulmonary compromise mostly in curves > 100°
Rushton and Grevitt[24], 2013	Systematic review and meta-analysis	Meta-analysis (21 cohorts)	Mixed	HRQoL, pain, self-image	Self-image impaired; function and pain largely preserved
Gremeaux et al[22], 2009	Cross-sectional long-term follow-up study	38 women, > 30 years	Various	Spinal height loss, disability	Greater spinal height loss with age; limited functional impact
Danielsson and Hallerman[30], 2015	Retrospective case series	Middle-aged patients, > 30 years	Not reported (early onset)	Self-image, function	Quality of life generally preserved; body image remained a concern in some
Danielsson and Nachemson[59], 2001	Retrospective matched case-control	Women, 22-year follow-up	Approximately 50°	Pregnancy outcomes, pain	Normal fertility and pregnancy outcomes
Nachemson[27], 1968	Retrospective cohort	Unknown (early study)	> 100°	Mortality, disability	Increased mortality noted, but likely due to inclusion of non-idiopathic scoliosis
Collis and Ponseti[31], 1969	Retrospective cohort	Long-term cohort	Various	Long-term function	No significantly impaired function or life expectancy
Agabegi et al[35], 2015	Systematic review	Not reported	Various	Risk factors, progression	Identify key predictors of progression in untreated cases
Luo et al[17], 2025	Systematic review and meta-analysis	Not reported	Various	Radiographic predictors	Curve pattern, flexibility, and apex location affect progression
Gremeaux et al[34], 2008	Cross-sectional analysis	Adults with scoliosis	Various	Back pain	Back pain increased but not disabling

HRQoL: Health-related quality of life; PROM: Patient-reported outcome measure; ODI: Oswestry Disability Index; AIS: Adolescent idiopathic scoliosis.