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In Reply: Dr Hawes characterizes our sample as geographically localized. Patients were initially seen at the same medical center but had dispersed to 22 US states and Canada by the 50-year follow-up. Concerning the representativeness of our control group, we sought volunteers based on age and sex alone from 2 dermatology clinics, a walk-in senior center, and the independent living unit of a retirement home. These are appropriate venues considering the age of our sample.

Concerning pulmonary function, Branthwaite is very clear: "Patients developing scoliosis at or after the age of 11 have a good prognosis, and cardiorespiratory disability is exceptional unless cardiac or pulmonary disease are present independently."¹ The work by Fraser and Pare, which Hawes cites, also states that "deformity of sufficient degree to cause symptoms and signs of cardiac or pulmonary disease is rare."²

We previously reported results of pulmonary function tests in the 1981 forty-year follow-up.³ . . . [Full Text of this Article]

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Health and Function of Patients With Untreated Idiopathic Scoliosis
Martha C. Hawes
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