Treatment of Scoliosis-Evidence and Management (Review of the Literature)

Weiss, Hans‐Rudolf; Turnbull, Deborah; Tournavitis, Nicos; Borysov, Maksym

doi:10.17795/mejrh-35377

Cited by 12 publications

(13 citation statements)

References 42 publications

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“…According to the current literature, to provide a balanced view regarding risks and benefits of surgical treatment in patients with AIS, we have to take into account that: (1) no high-quality evidence is available to support the claim that spinal fusion surgery may improve signs and symptoms of AIS [22242526525758] and (2) surgery carries many risks and other, yet unknown long-term consequences [2253596061]. …”

Section: Discussionmentioning

confidence: 99%

“…Despite this, it should be noted that there are no long-term results available for these procedures, and it is not clear whether the signs and symptoms of scoliosis, i.e., severe pain, cardiopulmonary compromise, lack of social participation, and early death can be prevented in the long-term in EOS cases [57]. One study with a follow-up of up to twenty years after the first double-rod instrumentation showed a significant rate of re-operation [53].…”

Section: Discussionmentioning

confidence: 99%

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Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Weiss¹,

Karavidas²,

Moramarco³

et al. 2016

Asian Spine J

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Currently, adolescent idiopathic scoliosis (AIS) is principally regarded as benign, but some researchers have cited serious or extreme effects, including severe pain, cardiopulmonary compromise, social isolation, and even early death. Therefore, exploration of the long-term effects of AIS, the most common type of idiopathic scoliosis, is warranted. The purpose of this review was to examine the long-term studies on the natural history of AIS and/or reviews concerning the long-term effects of untreated AIS. A PubMed search was conducted using the key words idiopathic scoliosis, long-term effects and idiopathic scoliosis, natural history. For further analysis, references cited in those studies were reviewed for additional, related evidence not retrieved in the initial PubMed search. A review of the pertinent bibliography showed that older natural history studies did not distinguish between late-onset scoliosis (referred to in this paper as AIS) and early-onset scoliosis (EOS). The more recent studies offer such important distinction and reach to the general conclusion that untreated AIS does not lead to severe consequences with respect to signs and symptoms of scoliosis. It is possible that earlier studies may have included patient populations with EOS, leading to the perception of untreated scoliosis as having an unusually high morbidity rate. Studies on the long-term effects of AIS that specifically excluded EOS patients conclude that AIS is a benign disorder. This indicates that for research and reporting purposes, it is important to distinguishing between AIS and EOS. This will allow the practitioner and patient and their families to decide on an optimal treatment plan based on the most appropriate prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Weiss¹,

Karavidas²,

Moramarco³

et al. 2016

Asian Spine J

Self Cite

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“…Treatment indications for scoliosis continue to be under debate [ 9 , 10 ]. Conservative treatment of scoliosis, both rehabilitative exercise and bracing, are recognized in literature reviews [ 11 - 14 ], Cochrane reviews [ 15 , 16 ] and randomized controlled studies [ 17 - 19 ]. Often, when a scoliosis reaches 45- 50º, surgery is the typical mode of treatment despite the absence of high-quality evidence [ 9 , 14 , 20 - 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…Conservative treatment of scoliosis, both rehabilitative exercise and bracing, are recognized in literature reviews [ 11 - 14 ], Cochrane reviews [ 15 , 16 ] and randomized controlled studies [ 17 - 19 ]. Often, when a scoliosis reaches 45- 50º, surgery is the typical mode of treatment despite the absence of high-quality evidence [ 9 , 14 , 20 - 25 ]. Comprehensive reviews [ 11 , 14 , 20 , 21 , 23 ] and two Cochrane reviews [ 23 , 24 ] failed to establish evidence supporting the position that surgery is superior to conservative treatment and/or to natural history [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Often, when a scoliosis reaches 45- 50º, surgery is the typical mode of treatment despite the absence of high-quality evidence [ 9 , 14 , 20 - 25 ]. Comprehensive reviews [ 11 , 14 , 20 , 21 , 23 ] and two Cochrane reviews [ 23 , 24 ] failed to establish evidence supporting the position that surgery is superior to conservative treatment and/or to natural history [ 1 , 2 ]. Recent comprehensive reviews show that the long-term risks of spinal fusion surgery are significant [ 14 , 20 , 26 , 27 ].…”

Section: Introductionmentioning

confidence: 99%

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A Prospective Cohort Study of AIS Patients with 40° and More Treated with a Gensingen Brace (GBW): Preliminary Results

Weiss¹,

Tournavitis²,

Seibel³

et al. 2017

TOORTHJ

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Introduction:There is a growing resistance from patients and their families to spinal fusion surgery for scoliosis. Due to inconclusive evidence that surgery has a long-term effect on scoliosis and/or improves the quality of life for patients with scoliosis, there is a need to extend the conservative perspective of treatment to patients with curvatures greater than 40 degrees. For that reason, a prospective cohort study was initiated to determine the effectiveness of the Gensingen brace (a Cheneau-style TLSO) in preventing progression in skeletally immature patients.Materials and Methods:Since 2011, fifty-five patients have been enrolled in this prospective cohort study. This report includes the mid-term results of twenty-five of these patients, who have a minimum follow-up of 18 months and an average follow-up of 30.4 months (SD 9.2). The twenty-five patients had the following characteristics at the start of treatment: Cobb angle: 49° (SD 8.4; 40º-71º); 12.4 years old (SD 0.82); Risser: 0.84 (SD 0.94; 0-2). A z-test was used to compare the success rate in this cohort to the success rate in the prospective braced cohort from BrAIST.Results:After follow-up, the average Cobb angle was 44.2° (SD 12.9). Two patients progressed, 12 patients were able to achieve halted progression, and eleven patients improved. Angle of trunk rotation (ATR) decreased from 12.2 to 10.1 degrees in the thoracic spine (p = 0.11) while the ATR decreased from 4.7 to 3.6 degrees in the lumbar spine (p = 0.0074). When comparing the success rate of the BrAIST cohort with the success rate of patients in this cohort, the difference was statistically significant (z = -3.041; p = 0.01).Conclusion:Conservative brace treatment using the Gensingen brace was successful in 92% of cases of patients with AIS of 40 degrees and higher. This is a significant improvement compared to the results attained in the BrAIST study (72%). Reduction of the ATR shows that postural improvement is also possible.

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The effect of Schroth Best Practice exercises and Cheneau brace treatment on perceptual and cognitive asymmetry in adolescent idiopathic scoliosis with thoracic major curve

Akçay,

İnanç

2023

Ir J Med Sci

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Treatment of Scoliosis-Evidence and Management (Review of the Literature)

Cited by 12 publications

References 42 publications

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

A Prospective Cohort Study of AIS Patients with 40° and More Treated with a Gensingen Brace (GBW): Preliminary Results

The effect of Schroth Best Practice exercises and Cheneau brace treatment on perceptual and cognitive asymmetry in adolescent idiopathic scoliosis with thoracic major curve

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