Abstract
BackgroundMedicine is a scientific art: once science is not clear, choices are made according to individual and collective beliefs that should be better understood. This is particularly true in a field like adolescent idiopathic scoliosis, where currently does not exist definitive scientific evidence on the efficacy either of conservative or of surgical treatments.Aim of the studyTo verify the philosophical choices on the final outcome of a group of people believing and engaged in a conservative treatment of idiopathic scoliosis.MethodsWe performed a multifaceted study that included a bibliometric analysis, a questionnaire, and a careful Consensus reaching procedure between experts in the conservative treatment of scoliosis (SOSORT members).ResultsThe Consensus reaching procedure has shown to be useful: answers changed in a statistically significant way, and 9 new outcome criteria were included. The most important final outcomes were considered Aesthetics (100%), Quality of life and Disability (more than 90%), while more than 80% of preferences went to Back Pain, Psychological well-being, Progression in adulthood, Breathing function, Scoliosis Cobb degrees (radiographic lateral flexion), Needs of further treatments in adulthood.DiscussionIn the literature prevail outcome criteria driven by the contingent treatment needs or the possibility to have measurement systems (even if it seems that usual clinical and radiographic methods are given much more importance than more complex Disability or Quality of Life instruments). SOSORT members give importance to a wide range of outcome criteria, in which clinical and radiographic issues have the lowest importance.ConclusionWe treat our patients for what they need for their future (Breathing function, Needs of further treatments in adulthood, Progression in adulthood), and their present too (Aesthetics, Disability, Quality of life). Technical matters, such as rib hump or radiographic lateral alignment and rotation, but not lateral flexion, are secondary outcomes and only instrumental to previously reported primary outcomes. We advocate a multidimensional, comprehensive evaluation of scoliosis patients, to gather all necessary data for a complete therapeutic approach, that goes beyond x-rays to reach the person and the family.
Highlights
Medicine is art: a scientific art, but always art [1,2]
We treat our patients for what they need for their future (Breathing function, Needs of further treatments in adulthood, Progression in adulthood), and their present too (Aesthetics, Disability, Quality of life)
When you start a treatment for adolescent idiopathic scoliosis, what do you want to obtain/avoid in adult age for your patient? What are your final outcomes? tuted the abstracts of the SOSORT Consensus meeting in Milan, January 2005, and have been sent out by e-mail, together with the Preliminary Program, to all the attendees of the 1st International Meeting on Conservative Management of Spinal Deformities held in January 2004 in Barcelona; the Questionnaires have been sent to all other people interested in the conservative treatment of adolescent idiopathic scoliosis that it was possible to retrieve according to indexed literature
Summary
Medicine is art because it implies the ability of a single physician to choose the correct medical means to obtain the right results in front of a specific patient, a person (with his unique characteristics) with a pathology (with his individual expression) [2]. It is a scientific art in the sense that it must be as much related to the literature as possible (evidence based medicine), but conjugated with our everyday experience (evidence based practice) [3,4,5,6,7]. This is true in a field like adolescent idiopathic scoliosis, where currently does not exist definitive scientific evidence on the efficacy either of conservative or of surgical treatments
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
