Every year, the Italian Scoliosis Study Group selects the best published papers on conservative spine treatment from the global scientific literature.
Here is the abstract from one of these papers. 

Spinal mobility and muscle function in middle-aged patients treated for early onset idiopathic scoliosis: compared with untreated and treated adolescent onset patients

Karin Romberg, Aina Danielsson, Monika Fagevik Olsén, Gunilla Kjellby-Wendt 

Spine Deform. 2022 Mar 23.PMID: 35091992 doi: 10.1007/s43390-021-00466-5

ABSTRACT

Purpose: To determine long-term outcome in terms of spinal range of motion (ROM) and trunk muscle endurance (TME) patients treated for idiopathic scoliosis, diagnosed before the age of ten, were evaluated and compared with untreated or treated patients with idiopathic scoliosis with adolescent onset (AIS).

Methods: Sixty-three braced and 53 operated patients underwent examination of spinal ROM and TME. Validated questionnaires were used for evaluation of back function.

Results: A total of 116 patients were examined 26.5 years after treatment. Braced EOS patients had longer bracing time and operated EOS patients had longer fusions compared to the respective AIS groups. Braced EOS patients had similar total ROM (thoracic ROM 40°, lumbar ROM 78°) and TME (trunk flexors 140 s, trunk extensors 255 s) as untreated AIS patients (thoracic ROM 34°, lumbar ROM 88°, trunk flexor endurance 158 s, trunk extensor endurance 234 s). Braced patients also had significantly better results than braced AIS patients. Operated EOS patients were slightly but significantly stronger and more mobile compared to AIS peers. The lumbar ROM was found to affect the back function in the operated EOS group (Oswestry Questionnaire, rs = 0.49, p < 0.001).

Conclusions: The braced EOS patients had mostly similar muscle strength and mobility as the untreated but younger AIS group, while the braced AIS group showed reductions of both strength and mobility. Similar significant, but small, differences were also found between operated EOS and AIS patients. Especially for muscle strength were findings at a level that would be of significant clinical importance.

Levels of evidence: III.

Keywords: Idiopathic scoliosis; Long term; Muscle function; Spinal mobility.

https://pubmed.ncbi.nlm.nih.gov/35320580/

Every year, the Italian Scoliosis Study Group selects the best published papers on conservative spine treatment from the global scientific literature.
Here is the abstract from one of these papers. 

Coronal deformity angular ratio as a predictive factor for in-brace curve correction

and long-term outcome of brace treatment in adolescents with idiopathic scoliosis

Taher Babaee, Mojtaba Kamyab, Mohammad Saleh Ganjavian, Naeimeh Rouhani, Adel Khorramrouz , James G Jarvis 

Spine Deform. 2022 Jan 16. PMID: 35034344 DOI: 10.1007/s43390-021-00452-x

Abstract

Purpose: To investigate the relationship between coronal deformity angular ratio (C-DAR) and in-brace correction (IBC) and their role in predicting the long-term bracing outcome in adolescents with idiopathic scoliosis (AIS).

Methods: In this retrospective multicenter study, the patient’s sex, age, primary curve Cobb angle (at initiation of brace treatment, best in-brace, before spinal fusion, and final follow-up), curve pattern, duration of brace treatment, brace type, and C-DAR at initiation of bracing were recorded. The C-DAR values were classified as < 5, 5 ≤ to ≤ 6, and > 6. The IBC values were classified as ≥ 50%, 40% ≤ to ≤ 49%, and < 40%. We classified the patients into two groups of success and failure according to the Cobb angle at the final follow-up.

Results: A total of 164 patients (25 boys and 119 girls) were included. Bracing was successful in 60.4% of them. There was a significant association between C-DAR and bracing outcome (p < 0.0001). 63.9% of the patients with C-DAR < 5 had an IBC ≥ 50%. However, when C-DAR was 5 ≤ to ≤ 6 and > 6, 29.2% and 16.9% of the patients had an IBC of ≥ 50%, respectively. For patients with IBC ≥ 50%, the success rate of bracing was 89.2%. Results of logistic regression analysis revealed that the strongest predictor for brace treatment outcome was the C-DAR, with an odds ratio of 2.11.

Conclusion: C-DAR may be used as a predictive factor for the long-term outcome of brace treatment in AIS.

Level of evidence: IV.

Keywords: Adolescent idiopathic scoliosis; Brace; Coronal deformity angular ratio; In-brace correction; Predictive factor.

https://pubmed.ncbi.nlm.nih.gov/35034344/

Every year, the Italian Scoliosis Study Group selects the best published papers on conservative spine treatment from the global scientific literature.
Here is the abstract from one of these papers. 

Kinesiophobia and its association with treatment choice in individuals with idiopathic scoliosis 

Gozde Yagci, Damlagul Aydin Ozcan, Cigdem Ayhan Kuru, Yavuz Yakut  

Back Musculoskelet Rehabil. 2021 Oct 29PMID: 34744071 DOI:10.3233/BMR-210111

Abstract

Background: Previous studies have reported increased kinesiophobia in adults with degenerative scoliosis or adolescents who have undergone spinal surgery. However, little is known about the phenomenon of kinesiophobia among adolescents with idiopathic scoliosis (IS).

Objectives: The aim of this study was to investigate levels of kinesiophobia and its association with treatment choice in IS.

Methods: The study included 98 IS patients with a mean age of 14 years and 20 healthy controls. Participants with IS were divided into groups based on treatment conditions, as follows: (1) untreated (n= 33); (2) treated with exercise (n= 32); and (3) treated with a brace (n= 33). Kinesiophobia was measured using the Tampa Scale for Kinesiophobia (TSK). Comparisons were made between four groups.

Results: Untreated participants with IS were found to have greater kinesiophobia than healthy controls (p< 0.001). Participants treated with a brace (p= 0.046) and exercise (p= 0.064) had similar kinesiophobia levels as the healthy control group.

Conclusions: Kinesiophobia was found to be higher in adolescents with IS compared to healthy peers. Brace or exercise treatment both had a positive impact on kinesiophobia. These findings should be considered when organizing rehabilitation programs to achieve the best results for adolescents with IS.

Keywords: Scoliosis; brace; exercise therapy; fear; movement.

https://pubmed.ncbi.nlm.nih.gov/34744071/

Every year, the Italian Scoliosis Study Group selects the best published papers on conservative spine treatment from the global scientific literature.
Here is the abstract from one of these papers. 

Long-term follow-up of untreated Scheuermann’s kyphosis

Enrique Garrido, Simon B Roberts, Andrew Duckworth, Joseph Fournier

Spine Deform. 2021 Nov;9(6):1633-1639. doi: 10.1007/s43390-021-00354-y

Abstract

Study design: Long-term cross-sectional study.

Objectives: To investigate the long-term effects of untreated Scheuermann’s kyphosis on quality of life, and its relationship to radiographic parameters of spinal deformity. Previous studies reported reduced self-image, increased pain and impaired physical status. Little is known of the long-term impact of sagittal plane deformity in untreated SK.

Methods: One hundred and thirteen consecutive untreated patients with SK were identified from a national service database prior to 2000, when surgery was not offered at this unit. 81 of these patients were available for evaluation; 66 (81%) consented to questionnaire and clinical evaluation, and 47 (58%) consented to additional radiological evaluation. Health-related quality of life (HRQoL) was compared to normative population values. Mean age was 45.1 years (31-65), and mean follow-up was 27 years (16-36). 57 patients had thoracic kyphosis and 9 had thoracolumbar deformity.

Results: SRS-22 and SF-36 scores were lower, and ODI was greater in patients with untreated SK compared to normative population values. Kyphosis progressed from mean 66° at skeletal maturity to 78° (p < 0.001) after mean follow-up of 27 years. Long-term progression of untreated SK was 0.45°/year (n = 47). Multilinear regression showed good correlation between increasing SVA and worse ODI scores (r = 0.59; p = 0.001). Increasing SVA also correlated with worse function, pain and mental health scores reported by SRS-22, and with worse physical function and bodily pain scores reported by SF-36. Increasing CL correlated with worse SF-36 physical function scores. Increasing cSVA and increasing TK correlated with worse SRS-22 self-image scores.

Conclusion: SRS-22 and SF-36 scores were lower, and ODI was greater in patients with untreated SK compared to normative data. Long-term progression of untreated SK was 0.45°/year (n = 47). Increasing SVA correlated with worse SF-36 physical function, SRS-22 function, SRS-22 pain and higher ODI scores. Total kyphosis (TK) and cSVA were independent predictors of low SRS self-image.

Level of evidence: III.

Keywords: Disease; Kyphosis; Natural history; Outcome; Scheuermann’s.

https://pubmed.ncbi.nlm.nih.gov/34212306/

Every year, the Italian Scoliosis Study Group selects the best published papers on conservative spine treatment from the global scientific literature.
Here is the abstract from one of these papers. 

Physical Functioning in Adolescents with Idiopathic Scoliosis: A Systematic Review of Outcome Measures and Their Measurement Properties

Samia Alamrani, Alison B Rushton, Adrian Gardner, Elena Bini, Deborah Falla, Nicola R Heneghan
PMID: 34033069 DOI: 10.1007/s43390-021-00365-9

Abstract

Study design: A systematic review.

Objective: To summarize evidence on measurement properties of Outcome Measures (OM) used to assess physical functioning in adolescents with idiopathic scoliosis (AIS).

Summary of background data: The AIS is a common spine deformity in those aged 10 to 18 years old. Associated health problems (e.g., back pain) significantly impact the quality of life (QoL). One important domain in QoL is physical functioning, which can be measured with patient-reported outcome measures (PROM), performance-based outcome measures (PBOM), and body structure and function OM. Adequate measurement properties of OM are important for precision in research and practice.

Methods: A two-staged search strategy was performed on electronic databases up to December 2019. Search one revealed a list of OM was used for physical functioning assessment in AIS. Search two identified studies that evaluated the measurement properties of OM in AIS; using the list identified in search one. Two independent reviewers determined study eligibility, risk of bias assessment (COnsensus-based Standards for the selection of health Measurement INstruments [COSMIN] checklist), and performed data extraction. The level of evidence was established using a modified GRADE approach.

Results: Search one yielded: 28 PROM, 20 PBOM, and 10 body structure and function OM. Search two revealed: 16 measurement properties studies for PROM, one for PBOM, and three for body structure and function measures. Construct validity, reliability, and responsiveness of most PROM has been established in AIS, but not content validity or internal consistency (moderate evidence). Construct validity was sufficient for the Timed Up and Go test and body structure and function measures (very low to low evidence).

Conclusion: Currently, physical functioning is evaluated with a variety of measures in AIS. The majority of measurement properties studies evaluated PROM with a paucity of information on measurement properties of PBOM and body structure and function OM. Based on COSMIN methodology, none of the OM identified in this review can be recommended with confidence in individuals with AIS.Level of Evidence: 2.

https://pubmed.ncbi.nlm.nih.gov/33496543/