{"id":7268,"date":"2021-12-14T04:32:12","date_gmt":"2021-12-14T04:32:12","guid":{"rendered":"https:\/\/scolicare.com\/naples-florida\/research-review-why-do-we-treat-adolescent-idiopathic-scoliosis\/"},"modified":"2021-12-14T04:32:12","modified_gmt":"2021-12-14T04:32:12","slug":"research-review-why-do-we-treat-adolescent-idiopathic-scoliosis","status":"publish","type":"post","link":"https:\/\/scolicare.com\/naples-florida\/research-review-why-do-we-treat-adolescent-idiopathic-scoliosis\/","title":{"rendered":"Research Review: Why Do We Treat Adolescent Idiopathic Scoliosis?"},"content":{"rendered":"<p><span style=\"font-weight: 400\">It is easy for patients and parents of patients to become focused on the Cobb angle as a measure of success or failure of treatment of scoliosis. Indeed, this may often stem from the treating medical team centering all treatment around the Cobb angle. However this paper by Negrini et al (2006) presented a more holistic way to consider the treatment of adolescents with idiopathic scoliosis. Should the focus of treatment extend beyond the Cobb angle (1)?\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">This paper was published in 2006, and at the time provided health professionals with the consensus from experts to help guide treatment of adolescent idiopathic scoliosis (AIS). The incentive for the paper was derived from the two schools of thought at the time:<\/span><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Wait for surgery (2-8)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">The need to act to treat patients and to avoid more invasive treatments in the future \u2018as much as possible\u2019 (9-16)<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Uncertainty regarding the need for treatment (1).\u00a0<\/span><\/li>\n<\/ol>\n<p><span style=\"font-weight: 400\">The publication of this consensus paper by the International Society of Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) resulted in a great resource to drive further research and treatment of AIS.\u00a0<\/span><\/p>\n<h3><strong>What do we Want to Obtain and to Avoid for our Patients?<\/strong><\/h3>\n<p><span style=\"font-weight: 400\">Just like any treatment plan, the goals of treatment must be derived with the patient at the centre of care. According to the consensus paper the goals of treatment for AIS include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">aesthetics\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">quality of life<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">disability\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">back pain\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">psychological wellbeing\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">progression in adulthood<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">breathing function\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">scoliosis Cobb degrees<\/span><\/li>\n<li><span style=\"font-weight: 400\">need for further treatment in adulthood (1).<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">The comprehensive list above really does also justify why the SOSORT guidelines advocate for a multidisciplinary team approach for AIS (17).\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">The other major consideration highlighted by this team of authors is the future of the patients. So, while the scoliosis may not be impacting the patient now, or perhaps the treating team (or indeed even the patient) may not see the treatment as a priority at this point, discussions should still be had about the future. There is no demand for dramatisation of the scoliosis. However, the consensus paper did point out that it is important to consider any potential future impacts on the patient, including:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">breathing function<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">the need for further treatment<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">progression into adulthood (1).<\/span><\/li>\n<\/ul>\n<h3><strong>What Should be the Major Focus of Scoliosis Treatment for AIS?\u00a0<\/strong><\/h3>\n<p><span style=\"font-weight: 400\">Interestingly, the authors of this SOSORT consensus paper pointed out that when working with a adolescent patient with idiopathic scoliosis the current major conside<\/span><span style=\"font-weight: 400\">rations should include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">aesthetics<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">disability<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">quality of life (1).<img loading=\"lazy\" decoding=\"async\" class=\"wp-image-17117 alignright\" src=\"https:\/\/scolicare.com\/wp-content\/uploads\/2021\/12\/iStock-92041710-resized-1100x853.jpg\" alt=\"Lower back scan\" width=\"442\" height=\"343\" \/><\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Engaging the patient to think beyond the Cobb angle may be easy with some patients and not so easy with others. Afterall, medicine is a \u2018scientific art\u2019 (18, 19). This means that, as the treating practitioner, it is imperative to use evidence-based practice but also to connect with the patient in a way so that the individual\u2019s beliefs are understood and considered within the treatment plan\u00a0 (9, 18-20).<\/span><\/p>\n<h3><strong>Take Home Message<\/strong><\/h3>\n<p><span style=\"font-weight: 400\">While the Cobb angle is an important part of the treatment considerations, there is so much more to consider in the treatment planning for adolescents with idiopathic scoliosis. Considering the needs of every single patient, and ensuring that the patient is at the centre of the treatment plan, will help to maximise the chances of \u2018success\u2019, however that may be defined for each adolescent.\u00a0<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><b>Reference:\u00a0<\/b><\/p>\n<ol>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Negrini, S., Grivas, T.B., Kotwicki, T. <\/span><i><span style=\"font-weight: 400\">et al.<\/span><\/i><span style=\"font-weight: 400\"> (2006) Why do we treat adolescent idiopathic scoliosis? What we want to obtain and to avoid for our patients. SOSORT 2005 Consensus paper. <\/span><i><span style=\"font-weight: 400\">Scoliosis<\/span><\/i><span style=\"font-weight: 400\"> 1, 4. <\/span><a href=\"https:\/\/doi.org\/10.1186\/1748-7161-1-4\"><span style=\"font-weight: 400\">https:\/\/doi.org\/10.1186\/1748-7161-1-4<\/span><\/a><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Dickson, RA. (1999). Spinal deformity&#8211;adolescent idiopathic scoliosis.Nonoperative treatment. Spine. 24:2601-2606.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Dickson, RA. (1989). Idiopathic scoliosis. Bmj 1989, 298:906-907.15.\u00a0<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Dickson RA (1984). Screening for scoliosis. Br Med J (Clin Res Ed) 1984, 289:269-270.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Dickson, RA. and Weinstein SL. (1999). Bracing (and screening)&#8211;yes or no? J Bone Joint Surg Br. 81:193-198.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Goldberg, CJ., Dowling, FE., Hall, JE., Emans, JB. (1993). A statistical comparison between natural history of idiopathic scoliosis and brace treatment in skeletally immature adolescent girls. Spine. 18:902-908.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Goldberg, CJ., Dowling, FE., Fogarty, EE., Moore, DP. (1995). School scoliosis screening and the United States Preventive Services Task Force. An examination of long-term results. Spine. 20:1368-1374.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Hawes, MC. (2003). Health and function of patients with untreated idiopathic scoliosis. JAMA. 289:2644; author reply 2644-5.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Negrini, S., Brambilla, C., Carabalona, R. (2004). Social Acceptability of Treatments for Adolescent Idiopathic Scoliosis. Pediatr Rehabil. 7:52-53.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Negrini, S., Aulisa, L. Ferraro, C., Fraschini, P., Masiero, S., Simonazzi, P., Tedeschi, C. and Venturin, A. (2005). Italian guidelines on rehabilitation treatment of adolescents with scoliosis or other spinal deformities. Eura Medicophys. 41:183-201.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Hawes, MC (2003). The use of exercises in the treatment of scoliosis: an evidence-based critical review of the literature. Pediatr Rehabil. 6:171-182.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Negrini, S., Antonini, G., Carabalona, R., Minozzi, S. (2003). Physical exercises as a treatment for adolescent idiopathic scoliosis. A systematic review. Pediatr Rehabil. 6:227-235.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Rigo, M., Reiter, C., Weiss, HR. (2003). Effect of conservative management on the prevalence of surgery in patients with adolescent idiopathic scoliosis. Pediatr Rehabil. 6:209-214.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Weiss, HR., Weiss, G., Schaar, HJ. (2002). Conservative management in patients with scoliosis&#8211;does it reduce the incidence of surgery? Stud Health Technol Inform. 91:342-347.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Winter, RB., Lonstein, JE. (1997). To brace or not to brace: the true value of school screening. Spine. 22:1283-1284.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Weiss, HR., Weiss, G. Schaar, HJ. (2003). Incidence of surgery in conservatively treated patients with scoliosis. Pediatr Rehabil.\u00a0 6:111-118.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Lawn, B. (1996). L&#8217;arte perduta di guarire. Italian Edition edition. Milano, Garzanti Editore; 1996:332.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Sacks, O. (1985). L&#8217;uomo che scambi\u00f2 sua moglie per un cappello. Volume Italiana edition. Milano, Adelphi Edizioni. 318.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Grol, R. and Grimshaw, J. (2003). From best evidence to best practice: effective implementation of change in patients&#8217; care. Lancet. 362:1225-1230.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Malterud, K. (2001).\u00a0 The art and science of clinical knowledge: evidence beyond measures and numbers. Lancet. 358:397-400.<\/span><\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>It is easy for patients and parents of patients to become focused on the Cobb angle as a measure of success or failure of treatment of scoliosis. Indeed, this may often stem from the treating medical team centering all treatment around the Cobb angle. However this paper by Negrini et&hellip;<\/p>\n","protected":false},"author":1,"featured_media":7271,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[40],"tags":[23,24,20,78,74,16],"ppma_author":[84],"class_list":["post-7268","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-scoliosis","tag-adolescent","tag-adult","tag-exercise","tag-idiopathic","tag-rehabilitation","tag-scoliosis"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Research Review: Why Do We Treat Adolescent Idiopathic Scoliosis? &#8211; ScoliCare Naples Florida<\/title>\n<meta name=\"robots\" content=\"noindex, follow\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Research Review: Why Do We Treat Adolescent Idiopathic Scoliosis? &#8211; ScoliCare Naples Florida\" \/>\n<meta property=\"og:description\" content=\"It is easy for patients and parents of patients to become focused on the Cobb angle as a measure of success or failure of treatment of scoliosis. 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