Intervention studies on scoliosis – Review of the reviews

IntroductionThe treatment of scoliosis is still a matter of debate. Although certain systematic reviews exist, neither the surgical nor the conservative community seems to acknowledge the evidence which has been gained thus far.AimThe aim of this review was to highlight the knowledge concerning the conservative and the operative approach in order to provide the clinician with a clear view concerning the current alternatives.Materials and methodsA PubMed search for outcome papers and reviews concerning the treatment of scoliosis has been performed in order to detect approaches with beneficial outcomes with respect to the Cobb angle, trunk deformity and other signs and symptoms of scoliosis.Results and discussionReal outcome papers (beginning of treatment in immature samples, and final results after the end of growth) have been found for brace treatment only. Some papers investigated mid-term effects of exercises, most were retrospective, few prospective and many included patient samples with questionable treatment indications. The papers on surgery do not seem to provide evidence enough to establish a beneficial cost and benefit relationship for the patient.ConclusionsPhysiotherapy in the treatment of scoliosis does not seem to be of evidence enough in the treatment of patients at risk for being progressive. Brace treatment is supported by Level II evidence with studies providing end-growth results and long-term results as well. Surgical treatment cannot be regarded as being evidence based.