Adolescent idiopathic scoliosis: Considerations for the transition to adulthood

This review highlights factors in the natural history of adolescent idiopathic scoliosis as patients transition into adulthood. These factors can guide treating surgeons in counseling patients about the risks and benefits of nonoperative and operative management. It addresses the optimal timing of treatment, "prophylactic" surgery vs. symptom-driven surgery, long-term risks of fusion surgery, and the effects of fusion surgery on childbearing. Finally, it discusses proposed schemes for following up patients with adolescent idiopathic scoliosis as adults. Scientific evidence on long-term outcomes and complications serves as the basis for joint decision making between surgeons and patients.