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New Guidelines for Scoliosis Research

Researchers are taking steps to improve studies on the subject of scoliosis (curvature of the spine). In order to compare one study to another, similar methods and measurements must be taken. The Scoliosis Research Society (SRS) has set up guidelines for all future studies. The guidelines will make it possible to compare the results of different treatment for children with scoliosis.

The editors of the Journal of Pediatric Orthopaedics report two studies in this month's journal using these guidelines. The guidelines direct who can be included in the study. These are called inclusion criteria.

The second set of guidelines are for measuring how well nonoperative treatment such as bracing works (effectiveness). These guidelines include how many patients had a curve that got worse and by how many degrees. They also kept track of how many patients were advised to have surgery. And they added up the number of patients who then had the operation.

The inclusion criteria states that all patients in the studies on bracing as a treatment for scoliosis have to be at least 10 years old when the brace was made. The main spinal curve has to be between 25 and 40 degrees. And for girls, they must not be more than one year past the start of their menstrual cycle.

The guidelines further state that all patients are to be followed for at least two years past skeletal maturity. Successful brace treatment means keeping the results until the child has stopped growing.

The editors also comment on the recent decision to stop school screening for scoliosis. This decision was made because it appears that there isn't enough evidence to show that school screening is cost effective.

Drs. Hensinger and Thompson agree that this decision is wrong. They predict there will be more children diagnosed with scoliosis later when the curve has progressed beyond a mild case. This may mean more complex surgery will be needed to correct the spinal curvature.

This policy may not change unless it can be proven that bracing or other nonoperative treatment can make a difference for children with mild to moderate curves.

References: Robert N. Hensinger, MD, and George H. Thompson, MD. Orthotic Management in Adolescent Idiopathic Scoliosis. Leveling the Playing Field. In Journal of Pediatric Orthopaedics. June 2007. Vol. 27. No. 4. Pp. 367.

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