Hi...
I found the following article this morning:
http://www.macleans.ca/topstories/he...19_100836_5800
Here's the text:
I'm not sure where this guy gets his information, but the Scoliosis Research Society funded a study, published in 1997, that showed definitively that bracing is effective in specific populations:
--Linda
I found the following article this morning:
http://www.macleans.ca/topstories/he...19_100836_5800
Here's the text:
Does bracing straighten a curved spine?
Decades-old treatment for scoliosis is supported by little scientific evidence
For decades, doctors have been prescribing braces for children with scoliosis -- a sideways curvature of the spine -- but there is actually little scientific evidence to support the practice. A team of Canadian and American researchers is hoping to change that.
Dr. James Wright, a co-investigator and surgeon-in-chief at the Hospital for Sick Children, says doctors aren't really sure braces reduce the risk of the curvature progressing to the point of requiring surgery. And wearing the uncomfortable and obtrusive device for several years could prove a heavy psychological burden for a teenager concerned about fitting in with her peers.
"I have to say to the family, I think they're probably effective, but I'm not absolutely certain," Wright says. "This is one of those things which is quite inconvenient, it's quite expensive and it has side-effects, which are what it does to the psyche of a growing adolescent."
Surgery, on the other hand, comes with "low but significant" risks for paralysis and blood transfusion, and could lead to long-term back problems as a result of the need to fuse the spine in a straightened position. "If we could reduce the risk of ultimate surgery, that would be a real benefit," Wright says.
Showing whether bracing actually works would also address a controversy over whether children should be checked for scoliosis at school or the doctor's office. Some medical organizations support this practice, while others recommend against it because of a lack of evidence for an effective treatment.
To determine whether bracing works, Dr. Wright and researchers at 19 other centres across North America are embarking on a five-year study in which they will randomly assign about 480 children (65 of them from Canada) to be fitted with a brace or simply observed. At the end of the study, they will see whether children who wore the brace were less likely to need corrective surgery.
The Canadian Institutes of Health Research and the Shriners hospital system have promised funding for seven centres involved in the $3.5-million US study, contingent on the U.S. National Institutes of Health picking up the rest of the tab.
The NIH turned down the group's initial request for funding but has given them permission to reapply this year.
Decades-old treatment for scoliosis is supported by little scientific evidence
For decades, doctors have been prescribing braces for children with scoliosis -- a sideways curvature of the spine -- but there is actually little scientific evidence to support the practice. A team of Canadian and American researchers is hoping to change that.
Dr. James Wright, a co-investigator and surgeon-in-chief at the Hospital for Sick Children, says doctors aren't really sure braces reduce the risk of the curvature progressing to the point of requiring surgery. And wearing the uncomfortable and obtrusive device for several years could prove a heavy psychological burden for a teenager concerned about fitting in with her peers.
"I have to say to the family, I think they're probably effective, but I'm not absolutely certain," Wright says. "This is one of those things which is quite inconvenient, it's quite expensive and it has side-effects, which are what it does to the psyche of a growing adolescent."
Surgery, on the other hand, comes with "low but significant" risks for paralysis and blood transfusion, and could lead to long-term back problems as a result of the need to fuse the spine in a straightened position. "If we could reduce the risk of ultimate surgery, that would be a real benefit," Wright says.
Showing whether bracing actually works would also address a controversy over whether children should be checked for scoliosis at school or the doctor's office. Some medical organizations support this practice, while others recommend against it because of a lack of evidence for an effective treatment.
To determine whether bracing works, Dr. Wright and researchers at 19 other centres across North America are embarking on a five-year study in which they will randomly assign about 480 children (65 of them from Canada) to be fitted with a brace or simply observed. At the end of the study, they will see whether children who wore the brace were less likely to need corrective surgery.
The Canadian Institutes of Health Research and the Shriners hospital system have promised funding for seven centres involved in the $3.5-million US study, contingent on the U.S. National Institutes of Health picking up the rest of the tab.
The NIH turned down the group's initial request for funding but has given them permission to reapply this year.
I'm not sure where this guy gets his information, but the Scoliosis Research Society funded a study, published in 1997, that showed definitively that bracing is effective in specific populations:
Bone Joint Surg Am. 1997 May;79(5):664-74. Related Articles, Links
A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis.
Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D.
Kalamazoo Center for Medical Studies, Michigan 49008, USA. rowe@kcms.msu.edu
With use of data culled from twenty studies, members of the Prevalence and Natural History Committee of the Scoliosis Research Society conducted a meta-analysis of 1910 patients who had been managed with bracing (1459 patients), lateral electrical surface stimulation (322 patients), or observation (129 patients) because of idiopathic scoliosis. Three variables - the type of treatment, the level of maturity, and the criterion for failure - were analyzed to determine which had the greatest impact on the outcome. We also examined the effect of the type of brace that was used and the duration of bracing on the success of treatment. The number of failures of treatment in each study was determined by calculating the total number of patients who had unacceptable progression of the curve (as defined in the study), who could not comply with or tolerate treatment, or who had an operation. The percentage of patients who completed a given course of treatment without failure, adjusted for the sample sizes of the studies in which that treatment was used, yielded the weighted mean proportion of success for that treatment. The weighted mean proportion of success was 0.39 for lateral electrical surface stimulation, 0.49 for observation only, 0.60 for bracing for eight hours per day, 0.62 for bracing for sixteen hours per day, and 0.93 for bracing for twenty-three hours per day. The twenty-three-hour regimens were significantly more successful than any other treatment (p < 0.0001). The difference between the eight and sixteen-hour regimens was not significant, with the numbers available. Although lateral electrical surface stimulation was associated with a lower weighted mean proportion of success than observation only, the difference was not significant, with the numbers available. This meta-analysis demonstrates the effectiveness of bracing for the treatment of idiopathic scoliosis. The weighted mean proportion of success for the six types of braces included in this review was 0.92, with the highest proportion (0.99) achieved with the Milwaukee brace. We found that use of the Milwaukee brace or another thoracolumbosacral orthosis for twenty-three hours per day effectively halted progression of the curve. Bracing for eight or sixteen hours per day was found to be significantly less effective than bracing for twenty-three hours per day (p < 0.0001).
A meta-analysis of the efficacy of non-operative treatments for idiopathic scoliosis.
Rowe DE, Bernstein SM, Riddick MF, Adler F, Emans JB, Gardner-Bonneau D.
Kalamazoo Center for Medical Studies, Michigan 49008, USA. rowe@kcms.msu.edu
With use of data culled from twenty studies, members of the Prevalence and Natural History Committee of the Scoliosis Research Society conducted a meta-analysis of 1910 patients who had been managed with bracing (1459 patients), lateral electrical surface stimulation (322 patients), or observation (129 patients) because of idiopathic scoliosis. Three variables - the type of treatment, the level of maturity, and the criterion for failure - were analyzed to determine which had the greatest impact on the outcome. We also examined the effect of the type of brace that was used and the duration of bracing on the success of treatment. The number of failures of treatment in each study was determined by calculating the total number of patients who had unacceptable progression of the curve (as defined in the study), who could not comply with or tolerate treatment, or who had an operation. The percentage of patients who completed a given course of treatment without failure, adjusted for the sample sizes of the studies in which that treatment was used, yielded the weighted mean proportion of success for that treatment. The weighted mean proportion of success was 0.39 for lateral electrical surface stimulation, 0.49 for observation only, 0.60 for bracing for eight hours per day, 0.62 for bracing for sixteen hours per day, and 0.93 for bracing for twenty-three hours per day. The twenty-three-hour regimens were significantly more successful than any other treatment (p < 0.0001). The difference between the eight and sixteen-hour regimens was not significant, with the numbers available. Although lateral electrical surface stimulation was associated with a lower weighted mean proportion of success than observation only, the difference was not significant, with the numbers available. This meta-analysis demonstrates the effectiveness of bracing for the treatment of idiopathic scoliosis. The weighted mean proportion of success for the six types of braces included in this review was 0.92, with the highest proportion (0.99) achieved with the Milwaukee brace. We found that use of the Milwaukee brace or another thoracolumbosacral orthosis for twenty-three hours per day effectively halted progression of the curve. Bracing for eight or sixteen hours per day was found to be significantly less effective than bracing for twenty-three hours per day (p < 0.0001).
--Linda
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