Abstract
Introduction Long-term follow-ups of untreated patients with adolescent idiopathic scoliosis (AIS) indicate that the consequences of AIS over a lifetime are minimal, sometimes moderate in more severe cases, however, never life-threatening. In light of these findings, the historical indications for treatment should be investigated according to current evidence. This critical review discusses the treatment methods for scoliosis. Materials and methods Recent reviews have been investigated for their contribution to evidence in the field of scoliosis treatment, especially the impact of t-he results obtained on the historical modes of treatment. Results From these findings, we may conclude that there is promising evidence for the application of physi-otherapy in the treatment of scolio-sis in children or adolescents and for adults with curvatures exceeding 35° Cobb. There is a stronger evidence for the application of (hard) braces during growth. There is no evidence for spinal fusion surgery for AIS. The use of surgery should be limited in patients with scoliosis of other ori-gin. Conclusion
Highlights
Long-term follow-ups of untreated patients with adolescent idiopathic scoliosis (AIS) indicate that the consequences of AIS over a lifetime are minimal, sometimes moderate in more severe cases, never life-threatening
The results as presented in literature are compromised by the fact that in most papers patient samples have been under treatment, which, according to the current guidelines would have no indication for treatment[11]
One paper contains a subgroup of patients at actual risk, but this sample has not been followed until skeletal maturity[12]
Summary
Long-term follow-ups of untreated patients with adolescent idiopathic scoliosis (AIS) indicate that the consequences of AIS over a lifetime are minimal, sometimes moderate in more severe cases, never life-threatening. In light of these findings, the historical indications for treatment should be investigated according to current evidence. This critical review discusses the treatment methods for scoliosis. Treatment indications for scoliosis are usually dependent on the magnitude of the curvature at presentation and the maturity of the patient[6,7] Scoliosis must be more accurately regarded as a three-dimensional deformity of the spine and trunk, which may progress quickly during periods of rapid growth[2,3,4,5].
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