A comparison between long term outcomes of surgical and orthotic management of scoliosis in adolescents

Orthotic and surgical management are the main approaches used to control scoliotic curve progression. Treatment options are selected based on the age of the patient and severity of scoliotic curve. Although previous studies have investigated the consequences of different treatment options in patients with idiopathic scoliosis, it is still not clear which approach (conservative or surgical) has more influence on controlling curve progression. The aim of this study was to compare the final results of scoliotic treatment using each approach. A search was conducted using appropriate key words in identified data bases including PubMed; ISI web of knowledge; Google scholar; Ebsco and Embase. Data extraction was done using PICO (population, intervention, comparison and outcomes). Finally the ‘Down and Black’ tool was used to assess the quality of selected studies. The initial search strategy yielded fifty studies. 9 studies were included for final analysis in this review. Studies were categorized as those which reported the number of scoliotic subjects treated with an orthosis who also had surgery and studies comparing outcomes of treatment modalities (surgery and conservative treatment (orthosis)). Results of this review indicated that orthotic treatment can control the rate of surgery in scoliotic subjects. Literature comparing between orthotic and surgical management focused mostly on specific parameters such as quality of life; well-being and pulmonary function. These parameters, demonstrated no significant difference between scoliotic subjects treated with surgery and bracing.