Very simply, investigator Dr. Hans-Rudolf Weiss told Reuters Health, there is no medical indication for surgery in patients with adolescent idiopathic scoliosis when treated on a high quality conservative basis.
Overall, as there is only a cosmetic indication for surgery, the patients have to decide themselves, and not the physician, who in many cases is affiliated with the surgical industry, he added.
The investigators found that the prevalence of scoliosis in PWS children is high (37.5%) and many (13%) had undergone brace treatment or surgery.
The outcomes were observed in 9 subjects in their outpatient database who had undergone conservative therapy. All had reached the age of at least 19 years by the time of the study and thus were not subject to significant residual growth.
All were treated conservatively with growth hormone, diet control and exercise. Curvature remained within 70 and improved in some of the patients. There was deterioration in 1 patient, but this was due to non-compliance with adequate brace wearing.
Considering the fact that the complications of patients with PWS undergoing this surgery are high and the health-related benefits of such surgery in this population remain controversial, the investigators conclude, the indication for conservative treatment seems safer than spinal fusion surgery in this specific population.
