This article is part of the supplement: 5th International Conference on Conservative Management of Spinal Deformities .

Oral presentation

Adolescent idiopathic scoliosis – a review of the treatments and evidence-based practice

Deborah Goodall¹ and Hans-Rudolf Weiss²

¹  Scoliosis UK Limited, 163 Sandringham Road, Watford, UK

²  Asklepios Katharina Schroth Spinal Deformities Rehabilitation Centre, Korczakstr. 2, Bad Sobernheim, Germany

corresponding author email

from 5^th International Conference on Conservative Management of Spinal Deformities
Athens, Greece. 3–5 April 2008

Scoliosis 2009, 4(Suppl 1):O68doi:10.1186/1748-7161-4-S1-O68

The electronic version of this abstract is the complete one and can be found online at: http://www.scoliosisjournal.com/content/4/S1/O68

Published:

15 January 2009

© 2009 Goodall and Weiss; licensee BioMed Central Ltd.

Background

Treatment options for Adolescent Idiopathic Scoliosis include: exercises; in-patient rehabilitation; braces and surgery. The indications for various treatment options are based on developmental and epidemiological aspects. The predicted outcomes are based on observational data and knowledge of the natural history of scoliosis. The goal of this review is to provide a synopsis of all treatments in relation to evidence-based practice.

Methods

A systematic review was performed to determine an outcome parameter for "rate of progression". Only prospective, controlled studies that considered the treatment versus the natural history were included. The search strategy included the terms; 'Adolescent Idiopathic Scoliosis'; 'Idiopathic Scoliosis'; 'natural history'; 'observation'; 'physiotherapy'; 'physical therapy'; 'rehabilitation'; 'bracing'; 'orthotics' and 'surgery'.

Results

Review of the retrospective studies support out-patient physiotherapy. One prospective controlled study supports treatment with the Scoliosis In-patient Rehabilitation (SIR). One prospective multi-centre study, one long-term prospective controlled study, and one meta-analysis study support bracing. There was no controlled study which supported surgery.

Conclusion

There is evidence supporting the conservative treatment for Adolescent Idiopathic Scoliosis, but it is weak. No substantial evidence is found to support surgical intervention. In order to develop substantial evidence-based recommendations for the use of any interventions, more controlled studies are necessary. This need is especially true for recommendations for invasive surgery.

References

1. Weiss HR, Goodall D: Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature.

   Scoliosis 3:9. PubMed Abstract | BioMed Central Full Text | PubMed Central Full Text

   2008 Aug 5;

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