I hope that link works. If not then go to:

POSNA 2011 Annual Meeting
POSNA 2011 One-Day Course 5/11/2011

May 11, 2011

This is the video:

Evidence Based Medicine in Adolescent Idiopathic Scoliosis Play Video

Presented By: Peter O. Newton, MD
Co-Authors: James O. Sanders, MD

They discuss MANY items of interest to our little group including:

1. inability of the San Diego group to replicate the Spinecor results (this inability of other groups to replicate the Montreal results is common knowledge at this point so no surprise there)

2. PT approaches - little to no evidence of changing natural history

3. Newton loved the BrAIST study because it got him off the hook about going on the record about the efficacy of bracing with his patients. Now that they are no longer enrolling patients, he lamented he has to address this with patients. Recall this comment when he later talks about the Katz study settling the bracing question... he is certainly being sarcastic. If he isn't then he needs to talk with some other researchers and especially math guys.

4. Katz et al bracing study - they got some more data from the authors and crunched it in a different way. The results as I understand them are huge overtreatment to get one success and real world efficacy much less than reported. As far as I can tell, this is just another way to say bracing appears to benefit only a small percentage of the population in agreement with earlier studies that estimated only about 10% at most benefit and that is just short time. If the bracing leaves a patient with a Cobb >30* then progression and damage is not unexpected in the out years.

5. evidence-based reviews of studies reveal the extent of what is not known moreso than what is known which I thought was a clever point. Much of the work in this field is still within personal surgical opinion. That is not necessarily bad in that there could be more than one right answer.