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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

Illustrative plot of the primary research themes across studies reporting on the surgical management of scoliosis. The single most relevant primary theme was selected for each study. The size of each circle is proportional to the number of studies for each primary theme. The circle locations and colors are arbitrary.
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Fig8: Illustrative plot of the primary research themes across studies reporting on the surgical management of scoliosis. The single most relevant primary theme was selected for each study. The size of each circle is proportional to the number of studies for each primary theme. The circle locations and colors are arbitrary.

Mentions: Studies most frequently investigated the effects of specific implants and specific surgical techniques (26%), followed by approaches and staging (21%), and indications for surgery (21%) (FigureĀ 8). Ten percent of studies investigated the selection of spinal levels for fusion, 5% investigated neuromonitoring, and 4% investigated strategies to manage blood loss. Three percent investigated anaesthesic management, 3% investigated bone grafts or the use of bone graft substitutes, and 2% investigated post-operative pain management. Only 35 studies (2%) investigated the prevention or management of surgical site infections, 32 (2%) investigated interventions to improve psychological outcomes, and 17 (1%) investigated post-operative rehabilitation.Figure 8


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)

Illustrative plot of the primary research themes across studies reporting on the surgical management of scoliosis. The single most relevant primary theme was selected for each study. The size of each circle is proportional to the number of studies for each primary theme. The circle locations and colors are arbitrary.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig8: Illustrative plot of the primary research themes across studies reporting on the surgical management of scoliosis. The single most relevant primary theme was selected for each study. The size of each circle is proportional to the number of studies for each primary theme. The circle locations and colors are arbitrary.
Mentions: Studies most frequently investigated the effects of specific implants and specific surgical techniques (26%), followed by approaches and staging (21%), and indications for surgery (21%) (FigureĀ 8). Ten percent of studies investigated the selection of spinal levels for fusion, 5% investigated neuromonitoring, and 4% investigated strategies to manage blood loss. Three percent investigated anaesthesic management, 3% investigated bone grafts or the use of bone graft substitutes, and 2% investigated post-operative pain management. Only 35 studies (2%) investigated the prevention or management of surgical site infections, 32 (2%) investigated interventions to improve psychological outcomes, and 17 (1%) investigated post-operative rehabilitation.Figure 8

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