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Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS)?

Weiss HR - Scoliosis (2007)

Bottom Line: Historically, the treatment options for AIS, the most common form of scoliosis are; exercises; in-patient rehabilitation; braces and surgery.Another aim is to help to improve the safety of patients who have surgery.By producing evidence-based information that can be used to develop guidelines that could aid both professionals and patients in making decisions about surgical and conservative options.Although 'Scoliosis' is the official journal of the SOSORT and is the main forum for experts in the field of conservative management of patients with spinal deformities, there needs to be more wide spread attempt to develop a fuller body of evidence focussing on spine surgery as well.

View Article: PubMed Central - HTML - PubMed

Affiliation: Asklepios Katharina Schroth, Spinal Deformities Rehabilitation Centre, Korczakstrasse 2, D-55566 Bad Sobernheim, Germany. hr.weiss@asklepios.com.

ABSTRACT
Historically, the treatment options for AIS, the most common form of scoliosis are; exercises; in-patient rehabilitation; braces and surgery. While there is evidence in the form of prospective controlled studies that Scoliosis Intensive Rehabilitation (SIR) and braces can alter the natural history of the condition, there is no prospective controlled study comparing the natural history with surgical treatment.One aim of the Scoliosis Society (SOSORT) should be; to help develop a body of research regarding the outcomes of conservative and operative treatment as well, and to highlight the problems of treatment indications in patients with AIS and other spinal deformities. Another aim is to help to improve the safety of patients who have surgery. By producing evidence-based information that can be used to develop guidelines that could aid both professionals and patients in making decisions about surgical and conservative options.Although 'Scoliosis' is the official journal of the SOSORT and is the main forum for experts in the field of conservative management of patients with spinal deformities, there needs to be more wide spread attempt to develop a fuller body of evidence focussing on spine surgery as well.

No MeSH data available.


Related in: MedlinePlus

Patient with a thoracic curve of 56° corrected to 53° in her Milwaukee brace adjusted in North America (upper line). With this little correction effect one can predict no favourable outcome after this treatment. The question to be asked is: Is this patient a non-responder? In a brace of the Chêneau type she gained an in-brace correction down to 27° and after 15 months of treatment she clinically improved and her curve (without the brace) was 36° (lower line).
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Figure 2: Patient with a thoracic curve of 56° corrected to 53° in her Milwaukee brace adjusted in North America (upper line). With this little correction effect one can predict no favourable outcome after this treatment. The question to be asked is: Is this patient a non-responder? In a brace of the Chêneau type she gained an in-brace correction down to 27° and after 15 months of treatment she clinically improved and her curve (without the brace) was 36° (lower line).

Mentions: Unfortunately many studies on bracing, mainly coming from the US, do not attempt to find ways to improve this measurement [10,11,14,22]. Whether a brace works or not seems to depend upon the fate of the individual patient and not on brace quality. Some SRS Surgeons introduced the term "brace responder" or "non-responder" [23] as if it was the patients fault when there is no successful outcome. No one attempts to explain why some patients are "non-responders" and with another brace the same patients are "responders" [24] (Fig. 2).


Is there a body of evidence for the treatment of patients with Adolescent Idiopathic Scoliosis (AIS)?

Weiss HR - Scoliosis (2007)

Patient with a thoracic curve of 56° corrected to 53° in her Milwaukee brace adjusted in North America (upper line). With this little correction effect one can predict no favourable outcome after this treatment. The question to be asked is: Is this patient a non-responder? In a brace of the Chêneau type she gained an in-brace correction down to 27° and after 15 months of treatment she clinically improved and her curve (without the brace) was 36° (lower line).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2266701&req=5

Figure 2: Patient with a thoracic curve of 56° corrected to 53° in her Milwaukee brace adjusted in North America (upper line). With this little correction effect one can predict no favourable outcome after this treatment. The question to be asked is: Is this patient a non-responder? In a brace of the Chêneau type she gained an in-brace correction down to 27° and after 15 months of treatment she clinically improved and her curve (without the brace) was 36° (lower line).
Mentions: Unfortunately many studies on bracing, mainly coming from the US, do not attempt to find ways to improve this measurement [10,11,14,22]. Whether a brace works or not seems to depend upon the fate of the individual patient and not on brace quality. Some SRS Surgeons introduced the term "brace responder" or "non-responder" [23] as if it was the patients fault when there is no successful outcome. No one attempts to explain why some patients are "non-responders" and with another brace the same patients are "responders" [24] (Fig. 2).

Bottom Line: Historically, the treatment options for AIS, the most common form of scoliosis are; exercises; in-patient rehabilitation; braces and surgery.Another aim is to help to improve the safety of patients who have surgery.By producing evidence-based information that can be used to develop guidelines that could aid both professionals and patients in making decisions about surgical and conservative options.Although 'Scoliosis' is the official journal of the SOSORT and is the main forum for experts in the field of conservative management of patients with spinal deformities, there needs to be more wide spread attempt to develop a fuller body of evidence focussing on spine surgery as well.

View Article: PubMed Central - HTML - PubMed

Affiliation: Asklepios Katharina Schroth, Spinal Deformities Rehabilitation Centre, Korczakstrasse 2, D-55566 Bad Sobernheim, Germany. hr.weiss@asklepios.com.

ABSTRACT
Historically, the treatment options for AIS, the most common form of scoliosis are; exercises; in-patient rehabilitation; braces and surgery. While there is evidence in the form of prospective controlled studies that Scoliosis Intensive Rehabilitation (SIR) and braces can alter the natural history of the condition, there is no prospective controlled study comparing the natural history with surgical treatment.One aim of the Scoliosis Society (SOSORT) should be; to help develop a body of research regarding the outcomes of conservative and operative treatment as well, and to highlight the problems of treatment indications in patients with AIS and other spinal deformities. Another aim is to help to improve the safety of patients who have surgery. By producing evidence-based information that can be used to develop guidelines that could aid both professionals and patients in making decisions about surgical and conservative options.Although 'Scoliosis' is the official journal of the SOSORT and is the main forum for experts in the field of conservative management of patients with spinal deformities, there needs to be more wide spread attempt to develop a fuller body of evidence focussing on spine surgery as well.

No MeSH data available.


Related in: MedlinePlus