The Natural history of idiopathic scoliosis in Jamaica - abstract

ABSTRACT

This study analyses 877 cases, 691 female and 186 male patients. Eighty-one of these cases were of the secondary form of scoliosis and the diagnosis of these is presented. The age of onset of the 796 idoipathic cases showed only 0.3 percent of the infantile type and 2.5 percent of the juvenile type. Both of these figures are less than in most other reported series. The study was begun in 1956 and records every case seen at the University's Orthopaedic Clinic which deals with scoliosis in Jamaica and several of the other Caribbean islands. The last two years, after 1966, have been excluded because many patients had had the condition for several years before they presented to hospital which would falsify any observations concerning the year of onset. The types of curve and their frequency are presented. Special attention was paid to the year of onset of the idiopathic variety which showed a remarkable increase after 1968. This observation has led to suggestions concerning the aetiology of idiopathic scoliosis which have been correlated with- a). The idiopathic type was found to be particularly common in patients from the three higher income groups in the community; b). The average heights of both male and female idiopathic scoliosis patients are over 2 cm greater than for normal children of similar age; c). The metacarpal indices similarly are greater than those found in normal children of similar age; d). The growth spurt starts earlier in patients with idiopathic scoliosis. These findings, together with the increased frequency up to 1983 and the subsequent decline in frequency which is continuing, suggest that social factors are of importance in the aetiology of the condition (AU)