16. Spine disorders in children and adolescents

Children grow and develop over time. The development over time of a certain condition is known as its ‘natural history’. This means that, without treatment, the condition improves spontaneously, remains unchanged or worsens. Knowledge of the natural history of the various growth disorders of the spine is important in order to be able to decide on a prognosis and be able to determine the (need for) different treatment options. A disorder with a mild natural history, with a chance of spontaneous improvement or low risk of progression, can of course often be treated very hesitantly. If, on the other hand, if it is almost certain that waiting will lead to a considerable deterioration of the existing situation, with sometimes a worse final result from treatment, it is much better to opt for timely and sometimes ‘aggressive’, possibly surgical, intervention.