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Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
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Examen de detección de escoliosis idiopática en adolescentes: Declaración de recomendación del grupo de trabajo de
, David C Grossman1, Susan J Curry2
1Kaiser Permanente Washington Health Research Institute, Seattle.
JAMA
|January 11, 2018
Resumen
La detección de la escoliosis idiopática en adolescentes de entre 10 y 18 años carece de evidencia sobre los beneficios y los daños. El Grupo de Trabajo de Servicios Preventivos de los Estados Unidos encontró datos insuficientes para determinar si el cribado mejora los resultados de salud a largo plazo.
Área de la Ciencia:
- Ortopedia pediátrica
- La medicina preventiva
- La medicina basada en la evidencia
Sus antecedentes:
- La escoliosis idiopática adolescente (EIA) es una curvatura de la columna vertebral que afecta a los niños de 10 a 18 años, lo que puede conducir a problemas de salud a largo plazo.
- La detección temprana y el tratamiento de la AIS pueden mitigar la progresión antes de la madurez esquelética.
- Las recomendaciones actuales para el cribado de AIS requieren una actualización de la evidencia.
Objetivo del estudio:
- Actualizar la recomendación del Grupo de Trabajo de Servicios Preventivos de los Estados Unidos (USPSTF) de 2004 sobre el cribado de la escoliosis idiopática en adolescentes asintomáticos.
- Evaluar las ventajas y los inconvenientes de la detección y el tratamiento de la EIA.
Principales métodos:
- Revisión sistemática de la evidencia sobre el cribado y el tratamiento de la EIA.
- Se centró en los beneficios y los daños del cribado en adolescentes asintomáticos.
- Evaluó la evidencia para el ejercicio, el apoyo y las intervenciones quirúrgicas.
Principales resultados:
- No hay evidencia directa que vincule el cribado de AIS con mejores resultados de salud o identifique daños del cribado.
- El brazalete puede retrasar la progresión de la curvatura en la EIA leve/moderada, pero la evidencia de resultados de salud a largo plazo en adultos es inadecuada.
- La evidencia sobre el ejercicio y los tratamientos quirúrgicos, y los daños del tratamiento, es insuficiente.
Conclusiones:
- El USPSTF encontró pruebas insuficientes para determinar el equilibrio de beneficios y daños de la detección de AIS en adolescentes.
- El USPSTF concluye que la detección de AIS en niños y adolescentes de 10 a 18 años es una declaración "I" (evidencia insuficiente).
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