1: Disabil Rehabil. 2008;30(10):799-807. Links
Adolescent idiopathic scoliosis (AIS) - an indication for surgery? A systematic review of the literature.Weiss HR.
Asklepios Katharina Schroth, Spinal Deformities Rehabilitation Centre, Bad Sobernheim, Germany.
hr.weiss@asklepios.com
PURPOSE: Historically, the treatment options for AIS, the most common form of scoliosis are: Exercises, in-patient rehabilitation, braces and surgery. While there is evidence in the form of prospective controlled studies that Scoliosis Intensive Rehabilitation (SIR) and braces can alter the natural history of the condition, there is no review on prospective controlled trials for surgical treatment. The aim of this review was to perform a systematic search of the Pub Med literature to reveal the evidence on scoliosis surgery. METHODS: A systematic review has been performed using the Pub Med database. Literature has been searched for the outcome parameter; 'rate of progression' and only prospective controlled studies that have considered the treatment versus the natural history have been included. RESULTS: No controlled study, not in the short, mid or long term, searched within the review, has been found to reveal evidence to support the hypothesis that the effects of surgery as a treatment option for AIS is superior to natural history. CONCLUSIONS: No evidence has been found in terms of prospective controlled studies to support surgical intervention from the medical point of view. In the light of the unknown long-term effects of surgery and in concluding on the lack of evidence already found that surgery might change the signs and symptoms of scoliosis, a randomized controlled trial (RCT) is long overdue. Until such a time that such evidence exists, there can be no medical indication for surgery. The indications for surgery are limited for cosmetic reasons in severe cases and only if the patient and the family agree with this.
PMID: 18432438 [PubMed - indexed for MEDLINE]
Related ArticlesThe treatment of adolescent idiopathic scoliosis (AIS) according to present evidence. A systematic review. [Eur J Phys Rehabil Med.
In other articles written by this author HR Weiss- some of their patients still need surgery despite their best efforts. I believe Schroth can be helpful but still fails and is confined to mostly adolescents. Bracing and PT are used.
I also wonder if this has been correctly translated from German.:confused: