Letter to the editor: evidence-based of nonoperative treatment in adolescent idiopathic scoliosis.

Abstract

Dear Editor, We would like to discuss the publication entitled Evidence-based of nonoperative treatment in adolescent idiopathic scoliosis [1] which we read with great interest. In his study, the author reviewed articles concerning adolescent idiopathic scoliosis (AIS). Honestly the objective of the study is noteworthy and we have some questions for author: (1) Scoliosis of less than 20° should be followed up in periodic outpatient visits at 4 to 6 month intervals, and new X-rays should be taken if progression is suspected [2]. Bracing is generally recommended for scoliosis between 30° and 45° before the termination of bone growth. Bracing has been shown to successfully prevent curve progression in 75% in this patient population [3]. The recommendations for the bracing study inclusion were based on patients aged 10 years and above, a Risser sign of 0 to 2, initial curve magnitude of 25° to 40° [4]. What is the authors' opinion on a correlation between scoliosis angle and the Risser sign at therapy planning with AIS patients? (2) What is the authors' opinion on Charleston and Providence braces? Have part-time or nighttime bracing any advantages with patient compliance? (3) Classification of idiopathic scoliosis is of utmost importance in defining curvature by physicians, physiotherapists and orthotic technicians and designing the treatment plan [5,6]. Which classification system (King, Peking Union Medical College-PUMC, Lenke) did the author use for providing guidance for patients with AIS? We appreciate the authors' comments on these concerns.