Spinal Bracing in Adolescent Idiopathic Scoliosis

Before the introduction of the poliomyelitis vaccination, paralysis due to poliovirus infection was a leading cause of spinal deformity in children and young adults. The severe, stiff spinal deformities associated with poliovirus infection were complicated by pulmonary dysfunction; spinal bracing, which was often ineffective in correcting the deformity or preventing the progression of scoliosis, also exacerbated restrictive pulmonary disease, pulmonary hypertension, and cor pulmonale. Today, coronal spinal deformity in children and young adults is nearly always adolescent idiopathic scoliosis: a flexible, three-dimensional, spinal curvature affecting primarily girls, beginning in adolescence, and very rarely leading to clinically significant cardiopulmonary disease. When . . .