Inclusion and assessment criteria for conservative scoliosis treatment

The efficacy of brace or conservative treatment in adolescent idiopathic scoliosis is controversial due to variations in inclusion and assessment criteria. This makes the interpretation of brace studies and their comparisons difficult. The Scoliosis Research Society recently introduced new standardized inclusion and assessment criteria for future brace studies. The inclusion criteria include: age 10 years or older at initiation of bracing, Risser sign 0-2, primary curve magnitude 25 to 40 degrees, no prior treatment, and females either premenarche or less than one year post-menarche. The assessment criteria include: percentage of patients with < or = 5 degree curve progression and percentage of patients with > or = 6 degree curve progression at skeletal maturity, percentage of patients who had surgery or recommended before skeletal maturity, percentage of patients with curves exceeding 45 degrees at maturity, and a minimum of 2 years follow-up beyond skeletal maturity for those patients felt to have been successfully treated. All patients treated irregardless of compliance are to be included in the results (intent to treat). The use of these criteria should assist in the determination of the effectiveness of brace treatment, as well as accurate comparison between patient groups and different braces.