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      Indications for conservative management of scoliosis (guidelines)

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          Abstract

          This guideline has been discussed by the SOSORT guideline committee prior to the SOSORT consensus meeting in Milan, January 2005 and published in its first version on the SOSORT homepage: http://www.sosort.org/meetings.php. After the meeting it again has been discussed by the members of the SOSORT guideline committee to establish the final 2005 version submitted to Scoliosis, the official Journal of the society, in December 2005.

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          The prediction of curve progression in untreated idiopathic scoliosis during growth.

          Eric Carlson, J W Lonstein (1984)
          We reviewed the cases of 727 patients with idiopathic scoliosis in whom the initial curve measured from 5 to 29 degrees. The patients were followed either to the end of skeletal growth or until the curve progressed. One hundred and sixty-nine patients (23.2 per cent) showed progression of the curve. The incidence of curve progression was found to be related to the pattern and magnitude of the curve, the patient's age at presentation, the Risser sign, and the patient's menarchal status. We found no correlation between progression of the curve and the patient's sex, Harrington factor, rotational prominence, family history, or radiographic measurements. A progression factor was calculated using the three strongest correlations available at initial examination: the magnitude of the curve, the Risser sign, and the patient's chronological age. A graph and nomogram are presented that can serve as a guide for advising patients' families and for planning continuing care.
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            The selection of fusion levels in thoracic idiopathic scoliosis.

            Thomas H. King, J Moe, Russell D. Bradford … (1983)
            From the material and data reviewed in our study of 405 patients, it appears that postoperative correction of the thoracic spine approximately equals the correction noted on preoperative side-bending roentgenograms. Selective thoracic fusion can be safely performed on a Type-II curve of less than 80 degrees, but care must be taken to use the vertebra that is neutral and stable so that the lower level of the fusion is centered over the sacrum. The lumbar curve spontaneously corrects to balance the thoracic curve when selective thoracic fusion is performed and the lower level of fusion is properly selected. In Type-III, IV, and V thoracic curves the lower level of fusion should be centered over the sacrum to achieve a balanced, stable spine.
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              Effectiveness of treatment with a brace in girls who have adolescent idiopathic scoliosis. A prospective, controlled study based on data from the Brace Study of the Scoliosis Research Society.

              A L Nachemson, Mark Peterson (1995)
              In a prospective study by the Scoliosis Research Society, 286 girls who had adolescent idiopathic scoliosis, a thoracic or thoracolumbar curve of 25 to 35 degrees, and a mean age of twelve years and seven months (range, ten to fifteen years) were followed to determine the effect of treatment with observation only (129 patients), an underarm plastic brace (111 patients), and nighttime surface electrical stimulation (forty-six patients). Thirty-nine patients were lost to follow-up, leaving 247 (86 per cent) who were followed until maturity or who were dropped from the study because of failure of the assigned treatment. The end point of failure of treatment was defined as an increase in the curve of at least 6 degrees, from the time of the first roentgenogram, on two consecutive roentgenograms. As determined with use of this end point, treatment with a brace failed in seventeen of the 111 patients; observation only, in fifty-eight of the 129 patients; and electrical stimulation, in twenty-two of the forty-six patients. According to survivorship analysis, treatment with a brace was associated with a success rate of 74 per cent (95 per cent confidence interval, 52 to 84) at four years; observation only, with a success rate of 34 per cent (95 per cent confidence interval, 16 to 49); and electrical stimulation, with a success rate of 33 per cent (95 per cent confidence interval, 12 to 60).(ABSTRACT TRUNCATED AT 250 WORDS)
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                Author and article information

                Journal
                Journal ID (nlm-ta): Scoliosis
                Title: Scoliosis
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1748-7161
                Publication date Collection: 2006
                Publication date (Electronic): 8 May 2006
                Volume: 1
                Page: 5
                Affiliations
                [1 ]Asklepios Katharina Schroth Spinal Deformities Rehabilitation Centre, Bad Sobernheim, Germany
                [2 ]ISICO (Italian Scientific Spine Institute), Milan, Italy
                [3 ]Instituto Èlena Salvá, Barcelona, Spain
                [4 ]University of Medical Sciences, Poznan, Poland
                [5 ]University of Arizona, Tucson AZ 85721, USA
                [6 ]Orthopaedic Department "Thriasion" General Hospital, Magula, Athens, Greece
                [7 ]Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
                [8 ]Landesklinik für Orthopädie, Müllner Hauptstr. 48, A-5020 Salzburg, Austria
                Article
                Publisher ID: 1748-7161-1-5
                DOI: 10.1186/1748-7161-1-5
                PMC ID: 1479370
                PubMed ID: 16759357
                SO-VID: 937c70b6-1e19-4941-b80f-1c3e231c8a58
                Copyright © Copyright © 2006 Weiss et al; licensee BioMed Central Ltd.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 15 December 2005
                Date accepted : 8 May 2006
                Categories
                Subject: Methodology

                ScienceOpen disciplines: Orthopedics
                Data availability:
                ScienceOpen disciplines: Orthopedics

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