Scoliosis questioning medicine podcast

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BACKGROUND: Although the efficacy of bracing for adolescent idiopathic scoliosis has been debated, recent evidence indicates a strong dose-response effect with respect to preventing curve progression of ≥6°. The purpose of this study was to investigate whether bracing, prescribed with use of current criteria, prevents surgery and how many patients must be treated with bracing to prevent one surgery. METHODS: Of 126 patients with adolescent idiopathic scoliosis measuring between 25° and 45° and with a Risser sign of ≤2, 100 completed a prospective study in which they were managed with a Boston brace fitted with a heat sensor that measured brace wear...

STUDY DESIGN: A quality-control Internet-based study using recognized quality scoring systems. OBJECTIVE: To evaluate the quality of information available on the Internet. SUMMARY OF BACKGROUND DATA: The quality of information available is of poor quality and unreliable, and this study was to determine if it has improved in line with the exponential increase in Internet-based information since the last time it was reviewed in 2005. METHODS: To identify potential Web sites, the 5 most commonly accessed search engines were identified and a search for "scoliosis" was performed on each...

STUDY DESIGN: Systematic review of interventions. OBJECTIVE: To evaluate the efficacy of scoliosis-specific exercise (SSE) in adolescent patients with adolescent idiopathic scoliosis (AIS). SUMMARY OF BACKGROUND DATA: AIS is a 3-dimensional deformity of the spine. Although AIS can progress during growth and cause a surface deformity, it is usually not symptomatic. However, in adulthood, if the final spinal curvature surpasses a certain critical threshold, the risk of health problems and curve progression is increased...

CONTEXT: Although school-based screening programs for adolescent idiopathic scoliosis are mandated in 26 states in the United States, few program outcomes data exist regarding the effectiveness of such programs. OBJECTIVE: To determine the effectiveness of a community-based school scoliosis screening program. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of children who attended kindergarten or first grade at public or private schools in Rochester, Minn, during 1979-1982...

PURPOSE: Recommendations addressing school screening for adolescents with idiopathic scoliosis are contradictory. Consequently a critical evaluation of the methodological quality of available systematic reviews, including those upon which these recommendations are based, was conducted. METHODS: Articles meeting the minimal criteria to be considered a systematic review were included for a best evidence synthesis, umbrella review of secondary studies. The primary outcome measure was "any recommendation addressing the continuation, or not, of school screening programs"...

STUDY DESIGN: This was a population-based retrospective study. OBJECTIVE: To fully estimate the costs of the Hong Kong scoliosis screening program through a large, population-based study. SUMMARY OF BACKGROUND DATA: School screening for scoliosis has often been criticized for having high costs. In fact, the screening cost that has reported varied widely, from less than 1 to more than 30 US dollars (USD) per child screened. This variation is mainly due to the incomplete inclusion of cost items...

In 2004, the US Preventive Services Task Force called for an end to scoliosis screening in US public schools. However, screening endures, although most nations have ended their screening programs. Why? Explanations range from America's unique fee-for-service health care system and its encouragement of high-cost medical specialism to the nation's captivation with new surgeries and technologies. I highlight another, more historical, reason: the persistence of the belief that spinal curvature is a sign of a progressive disease or disability...

This editorial article initiates the school scoliosis screening thematic series of the Scoliosis journal. The various issues on screening policies are discussed; clinical and practical recommendations of setting up school screening programs are also described.

STUDY DESIGN: A meta-analysis that systematically reviewed the evaluation studies of a scoliosis screening program reported in the literature. OBJECTIVE: To evaluate the best current evidence on the clinical effectiveness of school screening for adolescent idiopathic scoliosis. SUMMARY OF BACKGROUND DATA: The use of school scoliosis screening is controversial, and its clinical effectiveness has been diversely reported. METHODS: Data sources included 3 databases, namely, PubMed, Google scholar, CINAHL database, and the references from identified reviews and studies...

OBJECTIVE: The aim of this study was to test the hypothesis that screening for scoliosis is effective in reducing the need for surgical treatment. METHODS: The study was a case-control study. A total of 125 consecutive patients who were treated surgically for idiopathic scoliosis between January 2001 and October 2004 and who were born on or after January 1, 1984, were invited; 108 agreed to participate. A total of 216 control subjects were selected randomly and anonymously, matched with respect to age and gender...

PURPOSE: To provide a 5-year national overview of corrective spinal deformity surgery in the United Kingdom. METHODS: Since 2008, the British Scoliosis Society has collected predefined data on spinal deformity surgeries carried out by its members. Participating units collect and submit annual anonymised data pertaining to the number of deformity surgeries performed, age groups, aetiology (idiopathic versus non-idiopathic), mortality, deep infections and neurological deficit (complete, incomplete without resolution and incomplete with resolution)...