Scoliosis even when untreated, with mortality rates similar to the general population. Older beliefs that untreated idiopathic scoliosis necessarily progresses into severe (cardiopulmonary) disability by old age have been refuted by later studies. The many causes of scoliosis include spinal deformities, neuromuscular problems, and inherited diseases or conditions caused by the environment. An estimated 65% of scoliosis cases are idiopathic, about 15% are congenital, and about 10% are secondary to a neuromuscular disease. Idiopathic scoliosis represents a majority of cases, but its causes are largely unknown. Recent studies indicate potential heritability of the disorder. About 38% of variance in scoliosis risk
Scoliosis disease, but whether it changes quality of life, appearance, or back pain is unclear. Surgery is usually recommended by orthopedists for curves with a high likelihood of progression (i.e., greater than 45 to 50° of magnitude), curves that would be cosmetically unacceptable as an adult, curves in patients with spina bifida and cerebral palsy that interfere with sitting and care, and curves that affect physiological functions such as breathing. Surgery is indicated by the Society on Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) at 45 to 50° and by the Scoliosis Research Society (SRS) at a Cobb angle of 45°. SOSORT