THE ADOLESCENTS’ SCOLIOSIS MORE AND MOREFREQUENTLY ARRIVE TO THE FIRST ORTHOPAEDICOBSERVATION WITH SEVERE CURVE: HOW AND WHY

Introduction: It is correct to affirm that thanks to the spreading diffusion of diagnostic centers, community medicine, healthcare provided paediatric medicine and scholastic medicine, in the third millennium serious or severe idiopathic scoliosis will probably never be observed again, considering the well know and scientifically proven effectiveness of orthopaedic treatment. In order to achieve satisfying results exact nosologic identification of the pathology and correct indication to therapy are essential, as well as an early intervention to minimize the inevitable progression, distinctive of this pathology, and the continuation of a proper treatment until reaching of skeletal maturity, estimated using Risser test. Not included in the previous analysis is the less frequent so-called ‘‘very severe’’ scoliosis, where curves get worse despite the treatment, even if correctly applied. Nevertheless at the Center for Diagnosis and Treatment of Scoliosis of the Policlinico Federico II di Napoli, scoliosis measuring more than 70 at first examination are still observed. This element could point out the failure of the national healthcare system, of scholastic and paediatric medicine, and of the family system. Objectives: Authors highlight the flaws of the national healthcare system about the missing or unsatisfactory territorial screening, the failure of scholastic and paediatric medicine, and the weakness of the family system owing to the poor communication between parents and children. Moreover they pay attention to often inadequate conservative treatments, performed by centers lacking specific competence, as well as to popular but ineffective therapies adopted by posturologists, chiropractors, dentists and similar. Materials and methods: Between 2009 and 2011, 12 cases of idiopathic scoliosis had been surgically treated, measuring on average more than 70 at first orthopaedic observation. The anamnesis showed in all cases a delay in the diagnosis or the previous performing of a not adequate treatment. Results and conclusions: Illustration of good middle and short term results of surgery and post-surgery protocol in the presented cases. Authors underline the importance, within the national health system, of proposing prevention as the first and most effective therapy of idiopathic scoliosis