Conservative treatment for adolescent idiopathic scoliosis: can it reduce the incidence of surgical treatment?

Abstract

Since 1986, the authors have been conducting conservative treatment for idiopathic scoliosis with the combination of brace treatment and physical treatment (side shift exercise and hitch exercise). A total of 328 female patients with adolescent idiopathic scoliosis who were at least 10 years of age at the first visit, with Cobb angle of 10° at the minimum and followed until after 15 years of age or skeletal maturity were included. The average Cobb angle was 32.4° and the average age was 13.8 years at the first visit. Surgery was recommended when curvature progressed to >50°. Twenty of 328 patients (6.1%) with more severe curves to begin with (mean Cobb angle at admission of 48.5 ± 9.3°) progressed to 62.2 ± 8.5° and were treated with spinal fusion by the age of 16.0 ± 2.6 years. The remaining 308 patients, of comparable age at inception of treatment but with a smaller original mean Cobb angle (32.4 ± 11.1°), showed no significant increase in magnitude of curvature (mean 33.6 ± 11.5°) by the time of discharge (18.6 ± 3.1 years). The fact that curvature magnitude was maintained at <35° means that these patients will have a good prognosis for avoiding dramatic progression during adulthood.