Current Treatment Approaches in the Nonoperative and Operative Management of Adolescent Idiopathic Scoliosis

Cassella, Michelina; Hall, John E.

doi:10.1093/ptj/71.12.897

Cited by 43 publications

(27 citation statements)

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“…With the exception of a short-lived and fruitless effort in the 1980s to use 'electrical stimulation' of lateral spinal musculature as a therapy [10,21,34,115,116], the principles underlying scoliosis treatment have undergone no significant changes since the time of Hippocrates: Treatments including spinal fusion surgery are still based on trying to force curvatures back into alignment in the absence of any scientific or practical understanding of what caused the curve in the first place and what forces may still be at work holding it that way [61,62,111].…”

Section: Changes In the Modern Eramentioning

confidence: 99%

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

Hawes¹

2003

Pediatric Rehabilitation

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The loss of flexibility in a spinal curvature defines it as a structural spinal deformity; a curvature sufficiently mobile to resolve with a change in posture is a non-structural or 'functional' scoliosis which is within the normal limits of movement for a human spine. It, therefore, seems logical that exercise-based therapies designed to improve and/or maintain flexibility and range of motion of the spine and thorax would be useful in the treatment of scoliosis. Recognition of the importance of maintaining flexibility of the thoracic spinal column to avoid scoliosis-associated pulmonary dysfunction made the use of exercise-based therapies a topic of clinical interest in ancient Greece. In recent years, successful prevention of polio epidemics has resulted in a stable change in patient populations such that most individuals diagnosed with scoliosis do not suffer from irreversible central nervous system compromise. As a result, realistic opportunities to examine the role of exercise in treatment of scoliosis are available for the first time in history. A growing body of evidence from independent sources is consistent with the hypothesis that exercise-based approaches can be used effectively to reverse the signs and symptoms of spinal deformity and to prevent progression in children and adults.

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Section: Changes In the Modern Eramentioning

confidence: 99%

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

Hawes¹

2003

Pediatric Rehabilitation

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“…7 The predominance of this research has focused primarily on developing epidemiological profiles, examining prevalent risk factors, and identifying important prognostic 2,3,5,7,45,64 Little research has been devoted to examining the management of these patients and that which has been done appears to focus primarily on conditions such as spondylolisthesis and scoliosis. 13,47,54 Now that the occurrence of LBP related to nonspecific pathologies in adolescents is recognized, what is currently lacking in the literature is information related to the appropriate subgrouping and conservative clinical management of these patients.…”

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confidence: 99%

Children and Adolescents With Low Back Pain: A Descriptive Study of Physical Examination and Outcome Measurement

Clifford

Fritz

2003

J Orthop Sports Phys Ther

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Study Design: A retrospective, cohort study of children and adolescents with low back pain (LBP) referred to physical therapy. Objectives: To describe the clinical presentation, examination findings, and classification of children and adolescent patients with LBP, and to explore the concurrent validity of the Oswestry questionnaire as a disability measure in this group. Background: Little information is available regarding the clinical presentation, physical examination findings, and outcome assessment in children and adolescents with LBP. Methods and Measures: Charts were reviewed for historical, diagnostic, physical examination, and outcome information. Diagnoses given by the referring physicians were recorded. A treatmentbased classification was made for each subject. Descriptive statistics were calculated for all variables. The validity of the Oswestry questionnaire was examined. Results: The children and adolescents included in this study represented 5% (n = 25) of all cases of LBP referred to physical therapy. A greater percentage of patients had difficulty with extension than with flexion range of motion (ROM). Initial pain scores were lower if a specific pathology was present (P = .001). Initial pain and Oswestry scores were poorly correlated (r = 0.16). Forty-four percent (n = 11) of patients scored under the floor value of 12% on the Oswestry. Conclusion:The referral rate of children and adolescents with LBP seems to be low. Compared to adults, children and adolescents appear more likely to have a specific diagnosis given to them by their physician. The physical examination findings appear to indicate that spinal stabilization approaches may be beneficial for many patients. The Oswestry questionnaire may not be a valid tool for documenting changes in disability in these patients. Further research is needed on the conservative management of children and adolescents with LBP. J Orthop Sports Phys Ther 2003;33:513-522. Key Words: Clinical presentation, low back pain, lumbar spine, Oswestry, retrospective study O nce thought to be a rare occurrence almost always resulting from a serious etiology, recent studies suggest that low back pain (LBP) among children and adolescents is not uncommon. 2,3,5,10,11,34,43,58,66,72 This change in traditional thought has led to an increased emphasis on research into LBP in this population. 7 The predominance of this research has focused primarily on developing epidemiological profiles, examining prevalent risk factors, and identifying important prognostic Shannon N. Clifford, 6035 Forbes Tower, Pittsburgh, PA 15260. E-mail: sncst16@pitt.edu indicators related to children and adolescents with LBP. 2,3,5,7,45,64

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“…Mass scoliosis screening in school environment, provides the opportunity to diagnose the condition and make referral for appropriate medical care. 5 Early detection of the deformity is of paramount importance to prevent further progression of the scoliosis and to reduce number of surgeries for scoliosis. 6,7,8,9 Screening at school for the early detection of scoliosis has been introduced and being practiced in many countries.…”

Section: Introductionmentioning

confidence: 99%

Detection of Adolescent Idiopathic Scoliosis among Nepalese Children Through the School Screening Program

Pokharel

Lakhey

Kafle

et al. 2014

Nepal Ortho. Assoc. J.

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Introduction: Idiopathic Adolescent Scoliosis (IAS) is the commonest type of scoliosis without any known cause. There has been studies in different countries and population on IAS; and its prevalence rate varies for different population. There has been no reported study done in Nepal on prevalence of adolescent idiopathic scoliosis (AIS). The aim of this study was to detect and evaluate the prevalence of idiopathic adolescent scoliosis in school children in different parts of Nepal.Methods: This was a descriptive cross sectional study conducted at Þ ve schools from different geographical parts of Nepal, from January 2010 to December 2010. Scoliosis screening was done in 5 schools from different geographical locations of Nepal. Children (from grade 6 to 10; age more than 10 years) with positive Adam's forward bending test and scoliometer angle of 5 degrees or more were subjected for radiographic evaluation of the spine. The criterion for the diagnosis of scoliosis was detection of Cobb's angle of more than 10 degrees. Evaluation of scoliosis according to the age, gender, ethnic group, spinal region and magnitude of curve was done.Results: Out of 1094 children screened, 31 (2.83%) were referred for radiological evaluation; and 12 of them had lateral spinal curvature of more than 10 degrees. Hence the prevalence of scoliosis was 1.09%. The girl to boy ratio of distribution of scoliosis was 3:1 for larger curves of more than 20 degrees. Maximum number of scoliosis cases was seen in girls of 13 years, and the right sided thoracic scoliosis was most common. There is no ethnic predominance of scoliosis. Conclusion:Prevalence of idiopathic scoliosis among school children who need treatment in Nepal is low; however, school screening program has its epidemiological value.

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Current Treatment Approaches in the Nonoperative and Operative Management of Adolescent Idiopathic Scoliosis

Cited by 43 publications

References 0 publications

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature

Children and Adolescents With Low Back Pain: A Descriptive Study of Physical Examination and Outcome Measurement

Detection of Adolescent Idiopathic Scoliosis among Nepalese Children Through the School Screening Program

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