Immature idiopathic scoliosis

PURPOSE OF REVIEW: Infantile and juvenile idiopathic scoliosis remain difficult problems to assess and treat. Investigations and publications are assisting with our understanding of the underlying pathology and treatment methods. New concepts for operative management in the growing spine may lead to improved outcomes. RECENT FINDINGS: Neural axis abnormalities are of uncertain prevalence in immature scoliosis with varying percentages in the literature. Recent articles have been published to help better understand this and to define when magnetic resonance imaging is indicated. Many operative approaches have been applied without one approach yielding consistently outstanding results. Growing rod concepts and fusionless surgery have been ideas that are gaining favor in the treatment of immature scoliosis. SUMMARY: Infantile and juvenile scoliosis involves a deformity of the spine with significant potential for remaining growth, and thus the possibility of severe deformity and associated problems. Operative intervention is challenging as one attempts to control a progressive deformity while allowing for longitudinal spine growth. Intraspinal abnormalities may also confuse the management. This text will review the background of immature scoliosis, associated neural axis abnormalities, and treatment modalities.