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Evidence Lacking for Treatment of Adult Scoliosis

One way to find out what treatment works best for a condition is to perform a systematic review of the literature. To do this, researchers use computer searches to find published studies on specific topics.

In this article, the results of a systematic review for nonsurgical treatment of adult scoliosis was reported. Two physicians from the University of Rochester School of Medicine in Rochester, New York conducted the search. They used three main health care, nursing, and allied health databases.

The subject was confined to adults with spinal deformity from degenerative scoliosis. Nonoperative treatment that was reviewed included bracing or casting, physical therapy, chiropractic care, and steroid or epidural injections.

The authors give a report after a careful search and analysis. They say that none of these conservative methods was effective or more effective than any other treatment approach. Most of the evidence was based on very small case reports or expert opinion.

In some studies, the results showed good improvement but too much information was left out of the article to consider the data valid or reliable.

In other cases, treatment did not show any long-term carry over of improvement, but no mention was made of whether or not the patients followed through with the program required. Overall, the studies showed very weak evidence that conservative care for adult scoliosis is effective.

It appears that doctors must make their own decisions in this area. And they must do so without the benefit of guidelines backed by research. Clinical research is needed to help sort out the best approach to conservative care for adults with degenerative scoliosis or other deformity.

References: Clifford R. Everett, MD, MPH, and Rajeev K. Patel, MD. A Systematic Literature Review of Nonsurgical Treatment in Adult Scoliosis. In Spine. September 1, 2007. Vol. 32. No. Supplement. Pp. S130-S134.

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