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The surgical management of scoliosis: a scoping review of the literature.

Evaniew N, Devji T, Drew B, Peterson D, Ghert M, Bhandari M - Scoliosis (2015)

Bottom Line: Patient important outcomes including function, health-related quality of life, pain, and rates or re-operation were infrequently reported.Higher-quality studies are specifically needed to inform surgical indications, surgical approaches, surgical techniques, and implant selection.Engaging global partners may increase generalizability.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics, Department of Surgery, McMaster University, 293 Wellington St N, Suite 110, Hamilton, ON L8L 8E7 Canada.

ABSTRACT

Background: Scoping reviews are innovative studies that can map a range of evidence to convey the breadth and depth of a large field. An evidence-based approach to the wide spectrum of surgical interventions for scoliosis is paramount to enhance clinical outcomes. The objectives of this scoping review were to identify critical knowledge gaps and direct future research.

Methods: This study was completed according to the methodology of Arksey and O'Malley. Two reviewers performed duplicate systematic screening of eligibility. Studies were classified according to patient age, scoliosis etiology, outcomes reported, study design, and overall research theme.

Results: There were 1763 eligible studies published between 1966 and 2013. The literature focused on adolescents (83% of studies) with idiopathic scoliosis (72%). There was a dominance of observational designs (88%), and a paucity of randomized trials (4%) or systematic reviews (1%). Fifty six percent of studies were conducted in North America, followed by 23% in Europe and 18% in Asia. Few high-level studies investigated surgical indications, surgical approaches, surgical techniques, or implant selection. Patient important outcomes including function, health-related quality of life, pain, and rates or re-operation were infrequently reported.

Conclusions: Current research priorities are to (1) undertake high-quality knowledge synthesis and knowledge translation activities; (2) conduct a series of planning meetings to engage clinicians, patients, and methodologists; and (3) clarify outcome reporting and strategies for methodological improvement. Higher-quality studies are specifically needed to inform surgical indications, surgical approaches, surgical techniques, and implant selection. Engaging global partners may increase generalizability.

No MeSH data available.


Related in: MedlinePlus

Flow diagram depicting the screening and review of potentially eligible articles.
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Fig1: Flow diagram depicting the screening and review of potentially eligible articles.

Mentions: The search strategy identified 15913 potentially relevant articles (Figure 1). Of these, 9313 were removed because they were duplicate references to the same articles from multiple databases. A further 1786 were excluded during screening of titles and 1544 were excluded during screening of titles and abstracts because they either did not relate to surgery or they did not relate to scoliosis. Of 3270 articles eligible for full text review, 618 were excluded because they were narrative reviews, 424 were excluded because they were case reports, 343 were excluded because they were not available as full-texts in English, and 122 were excluded because they were not relevant or were duplicates. In total, 1763 studies were included for data extraction and further analysis. Agreement between the two reviewers for eligibility was satisfactory (kappa = 0.78).Figure 1


The surgical management of scoliosis: a scoping review of the literature.

Evaniew N, Devji T, Drew B, Peterson D, Ghert M, Bhandari M - Scoliosis (2015)

Flow diagram depicting the screening and review of potentially eligible articles.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307902&req=5

Fig1: Flow diagram depicting the screening and review of potentially eligible articles.
Mentions: The search strategy identified 15913 potentially relevant articles (Figure 1). Of these, 9313 were removed because they were duplicate references to the same articles from multiple databases. A further 1786 were excluded during screening of titles and 1544 were excluded during screening of titles and abstracts because they either did not relate to surgery or they did not relate to scoliosis. Of 3270 articles eligible for full text review, 618 were excluded because they were narrative reviews, 424 were excluded because they were case reports, 343 were excluded because they were not available as full-texts in English, and 122 were excluded because they were not relevant or were duplicates. In total, 1763 studies were included for data extraction and further analysis. Agreement between the two reviewers for eligibility was satisfactory (kappa = 0.78).Figure 1

Bottom Line: Patient important outcomes including function, health-related quality of life, pain, and rates or re-operation were infrequently reported.Higher-quality studies are specifically needed to inform surgical indications, surgical approaches, surgical techniques, and implant selection.Engaging global partners may increase generalizability.

View Article: PubMed Central - PubMed

Affiliation: Division of Orthopaedics, Department of Surgery, McMaster University, 293 Wellington St N, Suite 110, Hamilton, ON L8L 8E7 Canada.

ABSTRACT

Background: Scoping reviews are innovative studies that can map a range of evidence to convey the breadth and depth of a large field. An evidence-based approach to the wide spectrum of surgical interventions for scoliosis is paramount to enhance clinical outcomes. The objectives of this scoping review were to identify critical knowledge gaps and direct future research.

Methods: This study was completed according to the methodology of Arksey and O'Malley. Two reviewers performed duplicate systematic screening of eligibility. Studies were classified according to patient age, scoliosis etiology, outcomes reported, study design, and overall research theme.

Results: There were 1763 eligible studies published between 1966 and 2013. The literature focused on adolescents (83% of studies) with idiopathic scoliosis (72%). There was a dominance of observational designs (88%), and a paucity of randomized trials (4%) or systematic reviews (1%). Fifty six percent of studies were conducted in North America, followed by 23% in Europe and 18% in Asia. Few high-level studies investigated surgical indications, surgical approaches, surgical techniques, or implant selection. Patient important outcomes including function, health-related quality of life, pain, and rates or re-operation were infrequently reported.

Conclusions: Current research priorities are to (1) undertake high-quality knowledge synthesis and knowledge translation activities; (2) conduct a series of planning meetings to engage clinicians, patients, and methodologists; and (3) clarify outcome reporting and strategies for methodological improvement. Higher-quality studies are specifically needed to inform surgical indications, surgical approaches, surgical techniques, and implant selection. Engaging global partners may increase generalizability.

No MeSH data available.


Related in: MedlinePlus