Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis

Bettany‐Saltikov, Josette; Weiss, Hans-Rudolph; Chockalingam, Nachiappan; Taranu, Razvan; Srinivas, Shreya; Hogg, Julie; Whittaker, Victoria; Kalyan, Raman V.; Arnell, Tracey D.

doi:10.1002/14651858.cd010663.pub2

Cited by 75 publications

(87 citation statements)

References 54 publications

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“…There is a growing body of evidence concluding that surgery is rarely necessary for AIS [24252652] and that it is usually done for cosmetic and psychological purposes. Based on the current literature, Westrick and Ward [25] concluded that there is no medical necessity for surgery for AIS; this conclusion was recently confirmed by the results of a Cochrane review [26].…”

Section: Discussionmentioning

confidence: 99%

“…This is applicable to AIS patients with curve magnitudes of ≥40° with a potential for further growth and for those with curve magnitudes of ≥50° at or near skeletal maturity. This is standard practice, although there is a clear absence of high-level evidence for recommendation of spinal fusion surgery [2223242526]. Therefore, the indications for surgery need to be reevaluated based on the natural long-term effects of patients with AIS (the most prevalent population).…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Weiss¹,

Karavidas²,

Moramarco³

et al. 2016

Asian Spine J

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Currently, adolescent idiopathic scoliosis (AIS) is principally regarded as benign, but some researchers have cited serious or extreme effects, including severe pain, cardiopulmonary compromise, social isolation, and even early death. Therefore, exploration of the long-term effects of AIS, the most common type of idiopathic scoliosis, is warranted. The purpose of this review was to examine the long-term studies on the natural history of AIS and/or reviews concerning the long-term effects of untreated AIS. A PubMed search was conducted using the key words idiopathic scoliosis, long-term effects and idiopathic scoliosis, natural history. For further analysis, references cited in those studies were reviewed for additional, related evidence not retrieved in the initial PubMed search. A review of the pertinent bibliography showed that older natural history studies did not distinguish between late-onset scoliosis (referred to in this paper as AIS) and early-onset scoliosis (EOS). The more recent studies offer such important distinction and reach to the general conclusion that untreated AIS does not lead to severe consequences with respect to signs and symptoms of scoliosis. It is possible that earlier studies may have included patient populations with EOS, leading to the perception of untreated scoliosis as having an unusually high morbidity rate. Studies on the long-term effects of AIS that specifically excluded EOS patients conclude that AIS is a benign disorder. This indicates that for research and reporting purposes, it is important to distinguishing between AIS and EOS. This will allow the practitioner and patient and their families to decide on an optimal treatment plan based on the most appropriate prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Weiss¹,

Karavidas²,

Moramarco³

et al. 2016

Asian Spine J

Self Cite

View full text Add to dashboard Cite

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“…A Cochrane review carried out in 2015 found that no conclusion could be drawn from the literature with regard to surgical versus non-surgical interventions in severe AIS; this study was an ''empty review'' which nonetheless highlighted the alarming dearth of research in this field. 3 Likewise, an earlier review found no evidence that the health-related aspects of AIS can be altered in any significant way by surgical intervention, concluding that there is no medical justification for an intervention which is associated with a high rate of complications. scoliosis is not associated significantly with any physical impairment, other than shortness of breath and moderate back pain.…”

Section: Introductionmentioning

confidence: 99%

“…2 However at this time there is no clear consensus as to whether a minimally invasive approach is preferable to the open approach in terms of overall curve correction. Considering that there is also little evidence supporting the use of surgical techniques in the treatment of AIS when compared to less invasive techniques such as exercise or bracing, 3 these data call attention to the need for further research in this field far more eloquently than they support a particular intervention. When recommending interventions to their patients, physicians are not always guided by the best evidence, particularly when no such evidence exists; this phenomenon becomes especially clear when we consider the case of adolescent idiopathic scoliosis (AIS).…”

Section: Introductionmentioning

confidence: 99%

Minimally invasive surgery in the treatment of adolescent idiopathic scoliosis: A literature review and meta-analysis

Tarpada

Morris

2017

Journal of Orthopaedics

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“…These results have demonstrated the importance of intervention for further prevention of scoliosis progression. A study by Bettany-Saltikov et al compared conservative to surgical treatment of scoliosis and found no proof of preference of one way of treatment above the other one [10] . However, a systematic review by Yadla et al showed that surgical intervention has better radiographic and clinical outcomes for the patients [11] .…”

Section: Introductionmentioning

confidence: 99%

Scoliosis surgery, predictors and outcomes in a tertiary care hospital, Riyadh, KSA

Almalki¹,

Alanazi²,

Babiker³

et al. 2017

Int. J. Orthop. Sci.

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Background: Scoliosis is a back deformity, defined as structural lateral curvature of spine more than 10° (cobb angle) with rotation. Surgical intervention has better radiographic and clinical outcomes for the patients. However, it's not indicated in all cases and it's associated with certain complications. Methods: This is case series study which tracked subjects with scoliosis surgery. We investigated the data of all scoliosis surgery cases in our institution from 2009 to 2016 with internal board review approval. A data collection form was used to extract the data from the charts which included some demographic data such as age, gender, and date of birth, and indication of the procedure were included. Perioperative data such as operative time, blood loss, and perioperative death were estimated. Also, postoperative complications were included. Length of stay in hospital was calculated. Preoperative and postoperative recorded x-rays were interpreted and recorded. All of the reviewed data were coded and expelled into Excel sheet. Statistical package for social sciences (SPSS) version 22 was used for data analysis. Categorical variables were described by frequencies and percentages. Unpaired t-test was used to compare the pre and post-operative outcomes. Results: The mean age for the patients' who underwent the surgery is 17.7 (range, 8-56 years). 39% (32) of the sample is male and 61% (50) is female. The mean blood loss was 482.3 mL (range, 200-2900 mL) with the mean days of stay in hospital was 10 days (range, 4-90 days). The mean operative time was 250 minutes (range, 130-360 minutes). The most common indications for the surgery where neuromuscular scoliosis 36 (43.9%), idiopathic scoliosis 32 (39%). The mean cobb angel was 65° (range, 40°-116°) preoperatively and cobb angel of 16.1° (range, 0-87°) (P<0.001) postoperatively. Conclusion: Scoliosis surgery are effictive method of correcting different types of scolisos and are associated with minimal complications.

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Surgical versus non-surgical interventions in people with adolescent idiopathic scoliosis

Abstract: Bunge 2007 {published data only} Bunge EM, Juttmann RE, De Kleuver M, Van Biezen FC, De Koning HJ. Health-related quality of life in patients with adolescent idiopathic scoliosis after treatment: shortterm effects after brace or surgical treatment. European

Cited by 75 publications

References 54 publications

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Long-Term Effects of Untreated Adolescent Idiopathic Scoliosis: A Review of the Literature

Minimally invasive surgery in the treatment of adolescent idiopathic scoliosis: A literature review and meta-analysis

Scoliosis surgery, predictors and outcomes in a tertiary care hospital, Riyadh, KSA

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