People with AIS usually have no symptoms, however the resulting surface deformity frequently negatively impacts adolescents. In addition, increased curvature of the spine can present health risks in adulthood. Different types of treatment, including physical therapy, bracing, and surgery, are advocated depending on the magnitude of the curvature and area affected, truncal balance, general health, level of function and satisfaction, and patient’s and parent’s treatment desire.
Surgery is normally recommended in curvatures exceeding 40 to 50 degrees to stop the progression of the curvature. Short-term results of surgical treatment are improvements on outcome measures relating to self image, some functional aspects, and pain. However, the structured long-term follow-up needed to make meaningful conclusions is lacking. Recent papers highlight the long-term complications of surgery, while other papers postulate that the medium- and long-term complication rates following modern scoliosis surgery are low when compared to older techniques.
We searched the literature for both randomised controlled trials and prospective non-randomised studies with a control group examining the effects of surgical versus non-surgical treatments for teens with idiopathic scoliosis. The evidence is current to August 2014.
We identified no evidence examining the effectiveness of surgical interventions compared to non-surgical interventions for people with AIS. As a result, we cannot draw any conclusions regarding the benefits or harms of these treatments.