Skip to main content
The Western Journal of Medicine logoLink to The Western Journal of Medicine
. 1988 Feb;148(2):182–191.

Adolescent Idiopathic Scoliosis

Lawrence A Rinsky, James G Gamble
PMCID: PMC1026057  PMID: 3279708

Abstract

Adolescent idiopathic scoliosis is the single most common form of spinal deformity seen in orthopedic practice. Our knowledge about the epidemiology, etiology, natural history, and treatment has recently increased dramatically. The incidence of small curves is rather high (2% of the population), whereas severe curves are much less common (<0.1%), but we cannot always predict which curve will progress. Abnormalities of the neuromuscular system and of calcium metabolism, and certain growth, genetic, and mechanical factors may all play roles in the pathogenesis of the disorder. The physiologic secondary effects of severe scoliosis relate to restrictive lung disease, but most patients do not have a deformity great enough to affect their cardiorespiratory function. The psychological and social effects of scoliosis are significant for patients but difficult to quantitate. For most patients with moderate scoliosis—that is, more than 25 to 30 degrees—treatment with an underarm brace or electrical stimulation is adequate to “control” progression of the curve. Surgical fusion allows actual correction of the curve but is indicated in only a small percentage of patients—usually those with more than 50 degrees of deformity.

Full text

PDF
183

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adler N. S., Csongradi J., Bleck E. E. School screening for scoliosis. One experience in California using clinical examination and moiré photography. West J Med. 1984 Nov;141(5):631–633. [PMC free article] [PubMed] [Google Scholar]
  2. Adler N., Bleck E. E., Rinsky L. A., Young W. Balance reactions and eye-hand coordination in idiopathic scoliosis. J Orthop Res. 1986;4(1):102–107. doi: 10.1002/jor.1100040113. [DOI] [PubMed] [Google Scholar]
  3. Alexander M. A., Season E. H. Idiopathic scoliosis: an electromyographic study. Arch Phys Med Rehabil. 1978 Jul;59(7):314–315. [PubMed] [Google Scholar]
  4. Armstrong G. W., Livermore N. B., 3rd, Suzuki N., Armstrong J. G. Nonstandard vertebral rotation in scoliosis screening patients. Its prevalence and relation to the clinical deformity. Spine (Phila Pa 1976) 1982 Jan-Feb;7(1):50–54. doi: 10.1097/00007632-198200710-00006. [DOI] [PubMed] [Google Scholar]
  5. Ascani E., Bartolozzi P., Logroscino C. A., Marchetti P. G., Ponte A., Savini R., Travaglini F., Binazzi R., Di Silvestre M. Natural history of untreated idiopathic scoliosis after skeletal maturity. Spine (Phila Pa 1976) 1986 Oct;11(8):784–789. doi: 10.1097/00007632-198610000-00007. [DOI] [PubMed] [Google Scholar]
  6. Bjure J., Grimby G., Kasalický J., Lindh M., Nachemson A. Respiratory impairment and airway closure in patients with untreated idiopathic scoliosis. Thorax. 1970 Jul;25(4):451–456. doi: 10.1136/thx.25.4.451. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Bjure J., Nachemson A. Non-treated scoliosis. Clin Orthop Relat Res. 1973 Jun;(93):44–52. doi: 10.1097/00003086-197306000-00007. [DOI] [PubMed] [Google Scholar]
  8. Blount W. P., Mellencamp D. The effect of pregnancy on idiopathic scoliosis. J Bone Joint Surg Am. 1980 Oct;62(7):1083–1087. [PubMed] [Google Scholar]
  9. Brooks H. L., Azen S. P., Gerberg E., Brooks R., Chan L. Scoliosis: A prospective epidemiological study. J Bone Joint Surg Am. 1975 Oct;57(7):968–972. [PubMed] [Google Scholar]
  10. Brown J. C., Axelgaard J., Howson D. C. Multicenter trial of a noninvasive stimulation method for idiopathic scoliosis. A summary of early treatment results. Spine (Phila Pa 1976) 1984 May-Jun;9(4):382–387. doi: 10.1097/00007632-198405000-00010. [DOI] [PubMed] [Google Scholar]
  11. Bunnell W. P. An objective criterion for scoliosis screening. J Bone Joint Surg Am. 1984 Dec;66(9):1381–1387. [PubMed] [Google Scholar]
  12. Bunnell W. P., MacEwen G. D., Jayakumar S. The use of plastic jackets in the non-operative treatment of idiopathic scoliosis. Preliminary report. J Bone Joint Surg Am. 1980 Jan;62(1):31–38. [PubMed] [Google Scholar]
  13. Bunnell W. P. The natural history of idiopathic scoliosis before skeletal maturity. Spine (Phila Pa 1976) 1986 Oct;11(8):773–776. doi: 10.1097/00007632-198610000-00003. [DOI] [PubMed] [Google Scholar]
  14. Burwell R. G., James N. J., Johnson F., Webb J. K., Wilson Y. G. Standardised trunk asymmetry scores. A study of back contour in healthy school children. J Bone Joint Surg Br. 1983 Aug;65(4):452–463. doi: 10.1302/0301-620X.65B4.6874719. [DOI] [PubMed] [Google Scholar]
  15. Carman D., Roach J. W., Speck G., Wenger D. R., Herring J. A. Role of exercises in the Milwaukee brace treatment of scoliosis. J Pediatr Orthop. 1985 Jan-Feb;5(1):65–68. doi: 10.1097/01241398-198501000-00011. [DOI] [PubMed] [Google Scholar]
  16. Carr W. A., Moe J. H., Winter R. B., Lonstein J. E. Treatment of idiopathic scoliosis in the Milwaukee brace. J Bone Joint Surg Am. 1980;62(4):599–612. [PubMed] [Google Scholar]
  17. Cochran T., Irstam L., Nachemson A. Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusion. Spine (Phila Pa 1976) 1983 Sep;8(6):576–584. doi: 10.1097/00007632-198309000-00003. [DOI] [PubMed] [Google Scholar]
  18. Collis D. K., Ponseti I. V. Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg Am. 1969 Apr;51(3):425–445. [PubMed] [Google Scholar]
  19. Cowell H. R., Hall J. N., MacEwen G. D. Genetic aspects of idiopathic scoliosis. A Nicholas Andry Award essay, 1970. Clin Orthop Relat Res. 1972 Jul-Aug;86:121–131. doi: 10.1097/00003086-197207000-00018. [DOI] [PubMed] [Google Scholar]
  20. Dawson E. G., Smith R. K., McNiece G. M. Radiographic evaluation of scoliosis: a reassessment and introduction of the scoliosis Chariot. Clin Orthop Relat Res. 1978 Mar-Apr;(131):151–155. [PubMed] [Google Scholar]
  21. Dickson R. A., Lawton J. O., Archer I. A., Butt W. P. The pathogenesis of idiopathic scoliosis. Biplanar spinal asymmetry. J Bone Joint Surg Br. 1984 Jan;66(1):8–15. doi: 10.1302/0301-620X.66B1.6693483. [DOI] [PubMed] [Google Scholar]
  22. Driscoll D. M., Newton R. A., Lamb R. L., Nogi J. A study of postural equilibrium in idiopathic scoliosis. J Pediatr Orthop. 1984 Nov;4(6):677–681. doi: 10.1097/01241398-198411000-00004. [DOI] [PubMed] [Google Scholar]
  23. Drummond D., Ranallo F., Lonstein J., Brooks H. L., Cameron J. Radiation hazards in scoliosis management. Spine (Phila Pa 1976) 1983 Oct;8(7):741–748. doi: 10.1097/00007632-198310000-00010. [DOI] [PubMed] [Google Scholar]
  24. Edmonsson A. S., Morris J. T. Follow-up study of Milwaukee brace treatment in patients with idiopathic scoliosis. Clin Orthop Relat Res. 1977 Jul-Aug;(126):58–61. [PubMed] [Google Scholar]
  25. Eliason M. J., Richman L. C. Psychological effects of idiopathic adolescent scoliosis. J Dev Behav Pediatr. 1984 Aug;5(4):169–172. [PubMed] [Google Scholar]
  26. Emans J. B., Kaelin A., Bancel P., Hall J. E., Miller M. E. The Boston bracing system for idiopathic scoliosis. Follow-up results in 295 patients. Spine (Phila Pa 1976) 1986 Oct;11(8):792–801. doi: 10.1097/00007632-198610000-00009. [DOI] [PubMed] [Google Scholar]
  27. Floman Y., Liebergall M., Robin G. C., Eldor A. Abnormalities of aggregation, thromboxane A2 synthesis, and 14C serotonin release in platelets of patients with idiopathic scoliosis. Spine (Phila Pa 1976) 1983 Apr;8(3):236–241. doi: 10.1097/00007632-198304000-00003. [DOI] [PubMed] [Google Scholar]
  28. Ford D. M., Bagnall K. M., McFadden K. D., Greenhill B. J., Raso V. J. Paraspinal muscle imbalance in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 1984 May-Jun;9(4):373–376. doi: 10.1097/00007632-198405000-00008. [DOI] [PubMed] [Google Scholar]
  29. Fowles J. V., Drummond D. S., L'Ecuyer S., Roy L., Kassab M. T. Untreated scoliosis in the adult. Clin Orthop Relat Res. 1978 Jul-Aug;(134):212–217. [PubMed] [Google Scholar]
  30. Francis M. J., Sanderson M. C., Smith R. Skin collagen in idiopathic adolescent scoliosis and Marfan's syndrome. Clin Sci Mol Med. 1976 Nov;51(5):467–474. doi: 10.1042/cs0510467. [DOI] [PubMed] [Google Scholar]
  31. Fällström K., Cochran T., Nachemson A. Long-term effects on personality development in patients with adolescent idiopathic scoliosis. Influence of type of treatment. Spine (Phila Pa 1976) 1986 Sep;11(7):756–758. doi: 10.1097/00007632-198609000-00018. [DOI] [PubMed] [Google Scholar]
  32. Ghosh P., Bushell G. R., Taylor T. K., Pearce R. H., Grimmer B. J. Distribution of glycosaminoglycans across the normal and the scoliotic disc. Spine (Phila Pa 1976) 1980 Jul-Aug;5(4):310–317. doi: 10.1097/00007632-198007000-00004. [DOI] [PubMed] [Google Scholar]
  33. Green N. E. Part-time bracing of adolescent idiopathic scoliosis. J Bone Joint Surg Am. 1986 Jun;68(5):738–742. [PubMed] [Google Scholar]
  34. HARRINGTON P. R. Treatment of scoliosis. Correction and internal fixation by spine instrumentation. J Bone Joint Surg Am. 1962 Jun;44-A:591–610. [PubMed] [Google Scholar]
  35. Jackson R. P., Simmons E. H., Stripinis D. Incidence and severity of back pain in adult idiopathic scoliosis. Spine (Phila Pa 1976) 1983 Oct;8(7):749–756. doi: 10.1097/00007632-198310000-00011. [DOI] [PubMed] [Google Scholar]
  36. Kahanovitz N., Snow B., Pinter I. The comparative results of psychologic testing in scoliosis patients treated with electrical stimulation or bracing. Spine (Phila Pa 1976) 1984 Jul-Aug;9(5):442–444. doi: 10.1097/00007632-198407000-00002. [DOI] [PubMed] [Google Scholar]
  37. Kane W. J., Moe J. H. A scoliosis-prevalence survey in Minnesota. Clin Orthop Relat Res. 1970 Mar-Apr;69:216–218. [PubMed] [Google Scholar]
  38. Keiser R. P., Shufflebarger H. L. The Milwaukee brace in idiopathic scoliosis: evaluation of 123 completed cases. Clin Orthop Relat Res. 1976 Jul-Aug;(118):19–24. [PubMed] [Google Scholar]
  39. Kostuik J. P., Bentivoglio J. The incidence of low-back pain in adult scoliosis. Spine (Phila Pa 1976) 1981 May-Jun;6(3):268–273. doi: 10.1097/00007632-198105000-00009. [DOI] [PubMed] [Google Scholar]
  40. Kostuik J. P. Decision making in adult scoliosis. Spine (Phila Pa 1976) 1979 Nov-Dec;4(6):521–525. doi: 10.1097/00007632-197911000-00014. [DOI] [PubMed] [Google Scholar]
  41. Lawton J. O., Dickson R. A. The experimental basis of idiopathic scoliosis. Clin Orthop Relat Res. 1986 Sep;(210):9–17. [PubMed] [Google Scholar]
  42. Leaver J. M., Alvik A., Warren M. D. Prescriptive screening for adolescent idiopathic scoliosis: a review of the evidence. Int J Epidemiol. 1982 Jun;11(2):101–111. doi: 10.1093/ije/11.2.101. [DOI] [PubMed] [Google Scholar]
  43. Lonstein J. E., Bjorklund S., Wanninger M. H., Nelson R. P. Voluntary school screening for scoliosis in Minnesota. J Bone Joint Surg Am. 1982 Apr;64(4):481–488. [PubMed] [Google Scholar]
  44. Lonstein J. E., Carlson J. M. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg Am. 1984 Sep;66(7):1061–1071. [PubMed] [Google Scholar]
  45. Luque E. R. Segmental spinal instrumentation for correction of scoliosis. Clin Orthop Relat Res. 1982 Mar;(163):192–198. [PubMed] [Google Scholar]
  46. MacEwen G. D., Bunnell W. P., Sriram K. Acute neurological complications in the treatment of scoliosis. A report of the Scoliosis Research Society. J Bone Joint Surg Am. 1975 Apr;57(3):404–408. [PubMed] [Google Scholar]
  47. McCollough N. C., 3rd Nonoperative treatment of idiopathic scoliosis using surface electrical stimulation. Spine (Phila Pa 1976) 1986 Oct;11(8):802–804. doi: 10.1097/00007632-198610000-00010. [DOI] [PubMed] [Google Scholar]
  48. McCollough N. C., 3rd, Schultz M., Javech N., Latta L. Miami TLSO in the management of scoliosis: preliminary results in 100 cases. J Pediatr Orthop. 1981;1(2):141–152. doi: 10.1097/01241398-198110000-00004. [DOI] [PubMed] [Google Scholar]
  49. Mellencamp D. D., Blount W. P., Anderson A. J. Milwaukee brace treatment of idiopathic scoliosis: late results. Clin Orthop Relat Res. 1977 Jul-Aug;(126):47–57. [PubMed] [Google Scholar]
  50. Mellencamp D. D., Blount W. P. The natural history of idiopathic scoliosis. Late results revisited. Spine (Phila Pa 1976) 1986 Oct;11(8):805–806. [PubMed] [Google Scholar]
  51. Miller J. A., Nachemson A. L., Schultz A. B. Effectiveness of braces in mild idiopathic scoliosis. Spine (Phila Pa 1976) 1984 Sep;9(6):632–635. doi: 10.1097/00007632-198409000-00015. [DOI] [PubMed] [Google Scholar]
  52. Misol S., Ponseti I. V., Samaan N., Bradbury J. T. Growth hormone blood levels in patients with idiopathic scoliosis. Clin Orthop Relat Res. 1971 Nov-Dec;81:122–125. doi: 10.1097/00003086-197111000-00019. [DOI] [PubMed] [Google Scholar]
  53. Moskowitz A., Moe J. H., Winter R. B., Binner H. Long-term follow-up of scoliosis fusion. J Bone Joint Surg Am. 1980 Apr;62(3):364–376. [PubMed] [Google Scholar]
  54. Muirhead A., Conner A. N. The assessment of lung function in children with scoliosis. J Bone Joint Surg Br. 1985 Nov;67(5):699–702. doi: 10.1302/0301-620X.67B5.4055863. [DOI] [PubMed] [Google Scholar]
  55. Nachemson A. A long term follow-up study of non-treated scoliosis. Acta Orthop Scand. 1968;39(4):466–476. doi: 10.3109/17453676808989664. [DOI] [PubMed] [Google Scholar]
  56. Nachemson A. Adult scoliosis and back pain. Spine (Phila Pa 1976) 1979 Nov-Dec;4(6):513–517. doi: 10.1097/00007632-197911000-00011. [DOI] [PubMed] [Google Scholar]
  57. Nash C. L., Jr Current concepts review: scoliosis bracing. J Bone Joint Surg Am. 1980 Jul;62(5):848–852. [PubMed] [Google Scholar]
  58. Nash C. L., Jr, Gregg E. C., Brown R. H., Pillai K. Risks of exposure to X-rays in patients undergoing long-term treatment for scoliosis. J Bone Joint Surg Am. 1979 Apr;61(3):371–374. [PubMed] [Google Scholar]
  59. Nilsonne U., Lundgren K. D. Long-term prognosis in idiopathic scoliosis. Acta Orthop Scand. 1968;39(4):456–465. doi: 10.3109/17453676808989663. [DOI] [PubMed] [Google Scholar]
  60. Oda M., Rauh S., Gregory P. B., Silverman F. N., Bleck E. E. The significance of roentgenographic measurement in scoliosis. J Pediatr Orthop. 1982 Oct;2(4):378–382. doi: 10.1097/01241398-198210000-00005. [DOI] [PubMed] [Google Scholar]
  61. Oegema T. R., Jr, Bradford D. S., Cooper K. M., Hunter R. E. Comparison of the biochemistry of proteoglycans isolated from normal, idiopathic scoliotic and cerebral palsy spines. Spine (Phila Pa 1976) 1983 May-Jun;8(4):378–384. doi: 10.1097/00007632-198305000-00007. [DOI] [PubMed] [Google Scholar]
  62. Park J., Houtkin S., Grossman J., Levine D. B. A modified brace (Prenyl) for scoliosis. Clin Orthop Relat Res. 1977 Jul-Aug;(126):67–73. [PubMed] [Google Scholar]
  63. Pedrini V. A., Ponseti I. V., Dohrman S. C. Glycosaminoglycans of intervertebral disc in idiopathic scoliosis. J Lab Clin Med. 1973 Dec;82(6):938–950. [PubMed] [Google Scholar]
  64. Pin L. H., Mo L. Y., Lin L., Hua L. K., Hui H. P., Hui D. S., Chang B. D., Chang Y. Y., Yuan L. Early diagnosis of scoliosis based on school-screening. J Bone Joint Surg Am. 1985 Oct;67(8):1202–1205. [PubMed] [Google Scholar]
  65. Portillo D., Sinkora G., McNeill T., Spencer D., Schultz A. Trunk strengths in structurally normal girls and girls with idiopathic scoliosis. Spine (Phila Pa 1976) 1982 Nov-Dec;7(6):551–554. doi: 10.1097/00007632-198211000-00007. [DOI] [PubMed] [Google Scholar]
  66. Rogala E. J., Drummond D. S., Gurr J. Scoliosis: incidence and natural history. A prospective epidemiological study. J Bone Joint Surg Am. 1978 Mar;60(2):173–176. [PubMed] [Google Scholar]
  67. SHANDS A. R., Jr, EISBERG H. B. The incidence of scoliosis in the state of Delaware; a study of 50,000 minifilms of the chest made during a survey for tuberculosis. J Bone Joint Surg Am. 1955 Dec;37-A(6):1243–1249. [PubMed] [Google Scholar]
  68. Sahlstrand T. An analysis of lateral predominance in adolescent idiopathic scoliosis with special reference to convexity of the curve. Spine (Phila Pa 1976) 1980 Nov-Dec;5(6):512–518. doi: 10.1097/00007632-198011000-00005. [DOI] [PubMed] [Google Scholar]
  69. Sahlstrand T., Ortengren R., Nachemson A. Postural equilibrium in adolescent idiopathic scoliosis. Acta Orthop Scand. 1978 Aug;49(4):354–365. doi: 10.3109/17453677809050088. [DOI] [PubMed] [Google Scholar]
  70. Shneerson J. M., Sutton G. C., Zorab P. A. Causes of death, right ventricular hypertrophy, and congenital heart disease in scoliosis. Clin Orthop Relat Res. 1978 Sep;(135):52–57. [PubMed] [Google Scholar]
  71. Skogland L. B., Miller J. A. The length and proportions of the thoracolumbar spine in children with idiopathic scoliosis. Acta Orthop Scand. 1981;52(2):177–185. doi: 10.3109/17453678108991778. [DOI] [PubMed] [Google Scholar]
  72. Taylor T. K., Bushell G., Ghosh P. School screening for scoliosis: a look inside Pandora's box. Aust N Z J Surg. 1978 Aug;48(4):441–443. doi: 10.1111/j.1445-2197.1978.tb04898.x. [DOI] [PubMed] [Google Scholar]
  73. Terver S., Kleinman R., Bleck E. E. Growth landmarks and the evolution of scoliosis: a review of pertinent studies on their usefulness. Dev Med Child Neurol. 1980 Oct;22(5):675–684. doi: 10.1111/j.1469-8749.1980.tb04385.x. [DOI] [PubMed] [Google Scholar]
  74. Torell G., Nordwall A., Nachemson A. The changing pattern of scoliosis treatment due to effective screening. J Bone Joint Surg Am. 1981 Mar;63(3):337–341. [PubMed] [Google Scholar]
  75. Weinstein S. L., Ponseti I. V. Curve progression in idiopathic scoliosis. J Bone Joint Surg Am. 1983 Apr;65(4):447–455. [PubMed] [Google Scholar]
  76. Weinstein S. L., Zavala D. C., Ponseti I. V. Idiopathic scoliosis: long-term follow-up and prognosis in untreated patients. J Bone Joint Surg Am. 1981 Jun;63(5):702–712. [PubMed] [Google Scholar]
  77. Wilber R. G., Thompson G. H., Shaffer J. W., Brown R. H., Nash C. L., Jr Postoperative neurological deficits in segmental spinal instrumentation. A study using spinal cord monitoring. J Bone Joint Surg Am. 1984 Oct;66(8):1178–1187. [PubMed] [Google Scholar]
  78. Willner S. A study of growth in girls with adolescent idiopathic structural scoliosis. Clin Orthop Relat Res. 1974 Jun;(101):129–135. [PubMed] [Google Scholar]
  79. Winter R. B., Lonstein J. E., Drogt J., Noren C. A. The effectiveness of bracing in the nonoperative treatment of idiopathic scoliosis. Spine (Phila Pa 1976) 1986 Oct;11(8):790–791. doi: 10.1097/00007632-198610000-00008. [DOI] [PubMed] [Google Scholar]
  80. Winter R. B., Lovell W. W., Moe J. H. Excessive thoracic lordosis and loss of pulmonary function in patients with idiopathic scoliosis. J Bone Joint Surg Am. 1975 Oct;57(7):972–977. [PubMed] [Google Scholar]
  81. Wyatt M. P., Barrack R. L., Mubarak S. J., Whitecloud T. S., Burke S. W. Vibratory response in idiopathic scoliosis. J Bone Joint Surg Br. 1986 Nov;68(5):714–718. doi: 10.1302/0301-620X.68B5.3782230. [DOI] [PubMed] [Google Scholar]
  82. Wynne-Davies R. Familial (idiopathic) scoliosis. A family survey. J Bone Joint Surg Br. 1968 Feb;50(1):24–30. [PubMed] [Google Scholar]
  83. Yamada K., Yamamoto H., Nakagawa Y., Tezuka A., Tamura T., Kawata S. Etiology of idiopathic scoliosis. Clin Orthop Relat Res. 1984 Apr;(184):50–57. [PubMed] [Google Scholar]
  84. Yamamoto H., Tani T., MacEwen G. D., Herman R. An evaluation of brainstem function as a prognostication of early idiopathic scoliosis. J Pediatr Orthop. 1982;2(5):521–528. doi: 10.1097/01241398-198212000-00011. [DOI] [PubMed] [Google Scholar]
  85. Yarom R., Muhlrad A., Hodges S., Robin G. C. Platelet pathology in patients with idiopathic scoliosis: Ultrastructural morphometry, agrregations, x-ray spectrometry, and biochemical analysis. Lab Invest. 1980 Sep;43(3):208–216. [PubMed] [Google Scholar]
  86. Yarom R., Wolf E., Robin G. C. Deltoid pathology in idiopathic scoliosis. Spine (Phila Pa 1976) 1982 Sep-Oct;7(5):463–470. doi: 10.1097/00007632-198209000-00010. [DOI] [PubMed] [Google Scholar]
  87. Zetterberg C., Aniansson A., Grimby G. Morphology of the paravertebral muscles in adolescent idiopathic scoliosis. Spine (Phila Pa 1976) 1983 Jul-Aug;8(5):457–462. doi: 10.1097/00007632-198307000-00003. [DOI] [PubMed] [Google Scholar]
  88. Zorab P. A. Pulmonary function in spinal deformity. Clin Orthop Relat Res. 1973 Jun;(93):33–37. doi: 10.1097/00003086-197306000-00005. [DOI] [PubMed] [Google Scholar]

Articles from Western Journal of Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES