“It is very difficult to know precisely what the natural history of untreated surgical idiopathic scoliosis is, because most patients have surgical treatment of their curves when the Cobb measurement exceeds 50°. The only way of definitively proving that the natural history of surgical treatment of idiopathic scoliosis is better than untreated scoliosis would be to undertake a study involving a prospective, randomized group of patients with curves more than 50°, treated surgically with modern-day instrumentation and then compare the results with those of a similar group of untreated patients matched for age, deformity, and other parameters. Those two groups of patients would then have to be followed up in 10-year intervals to determine their relative function, pain and cosmetic appearance. No such study exists. If it were possible, it would take between 20 and 40 years to obtain a definitive answer.”
Too bad this was not written on a lunch napkin by a neighborhood quack, so that it could have been easily dismissed by many, but it was written by Keith H. Bridwell, MD a former President of SRS and was published in SPINE.
Dr. Bridwell is also the Asa C. and Dorothy W. Jones Professor of Orthopaedic Surgery at Washington University School of Medicine, and he is Chief of Pediatric and Adult Spinal Surgery in the Orthopaedic Department at Washington University in St. Louis.
What Dr Bridwell is saying that there is no solid proof that surgery gives a better outcome in Idiopathic Scoliosis than leaving it alone.
He also stated:
"Many surgeons feel that 50° is the surgical tidemark for treating idiopathic scoliosis … This “magic number” comes in part as an extrapolation from … studies of natural history and in part that most 50° curves are very visible cosmetically.”
Almost forgot the reference:
1: Bridwell KH. Surgical treatment of idiopathic adolescent scoliosis. Spine.
1999 Dec 15;24(24):2607-16. Review.
Links on Dr Bridwell
http://www.srs.org/professionals/mee...m03/photos.php
http://www.bridwell-spinal-deformity...keith-bridwell
Too bad this was not written on a lunch napkin by a neighborhood quack, so that it could have been easily dismissed by many, but it was written by Keith H. Bridwell, MD a former President of SRS and was published in SPINE.
Dr. Bridwell is also the Asa C. and Dorothy W. Jones Professor of Orthopaedic Surgery at Washington University School of Medicine, and he is Chief of Pediatric and Adult Spinal Surgery in the Orthopaedic Department at Washington University in St. Louis.
What Dr Bridwell is saying that there is no solid proof that surgery gives a better outcome in Idiopathic Scoliosis than leaving it alone.
He also stated:
"Many surgeons feel that 50° is the surgical tidemark for treating idiopathic scoliosis … This “magic number” comes in part as an extrapolation from … studies of natural history and in part that most 50° curves are very visible cosmetically.”
Almost forgot the reference:
1: Bridwell KH. Surgical treatment of idiopathic adolescent scoliosis. Spine.
1999 Dec 15;24(24):2607-16. Review.
Links on Dr Bridwell
http://www.srs.org/professionals/mee...m03/photos.php
http://www.bridwell-spinal-deformity...keith-bridwell
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