Background papers providing critical appraisal of the evidence and tentative recommendations prepared by the chapter author were pre-circulated to the members. Consensus was reached on final recommendations. Inclinometry and Moir topography have insufficient evidence for decision making. No controlled trials have shown screening or braces have better outcomes or a decrease in rate of spinal fusions than no screening for idiopathic adolescent scoliosis. Uncontrolled case series reports have shown that brace therapy limits the natural progression of scoliosis.
Corrections decrease over time, however.
Lateral electrical surface stimulation has better evidence to support its use. Some studies lacking controls or having methodology problems have suggested that exercise can reduce the need for more extensive treatment. Surgery is recommended for curvatures of more than 40 to 50 degrees and is done to reduce rib hump, correct spinal rotation, and obtain solid fusion and stability. Surgery reduces, but does not eliminate, spinal curvature. Early detection has not been shown to improve surgical outcomes.