Scoliosis Top 10

1. What are the best strategies for reducing or preventing the curve from getting worse, combining treatment and self-management approaches to avoid the need for surgery?
2. How is quality of life affected by scoliosis and its treatment? How can we measure this in ways that are meaningful to patients?
3. Could surgical procedures be improved to become less invasive, reduce scarring and increase flexibility?
4. What are the long-term outcomes and side-effects of surgery?
5. How likely is scoliosis to get worse over time, either with or without treatment? Should people be monitored?
6. What is the best method of imaging scoliosis that also reduces exposure to radiation?
7. Which type of brace (e.g. rigid or dynamic) is most effective in the treatment of (a) early onset scoliosis and (b) adolescent idiopathic scoliosis?
8. What forms of postural care are most effective (standing frames, seats, sleep suits & wheelchairs) for managing early onset, neuromuscular and syndromic scoliosis?
9. If scoliosis is diagnosed earlier, does this change the choice of treatment and/or lead to better outcomes?
10. How are the psychological impacts (including on body image) of diagnosis and treatment best managed?
11. Can the instrumentation (rods/ implants etc) cause harm in the short or long term?
12. How is scoliosis affected by hormonal changes in women (puberty, pregnancy and the menopause) and does this have implications for treatment using HRT?

The following questions were also discussed and put in order of priority at the workshop:

13. What are the most effective combinations of treatment (drugs, physiotherapy, alternative therapies) and self-management approaches (exercise, yoga) to manage pain post-surgery for scoliosis?
14. What are the long-term effects of bracing for children and adolescents with scoliosis (physically and emotionally)?
15. What are the most effective combinations of treatment (drugs, physiotherapy, alternative therapies) and self-management approaches (exercise, yoga) to manage the pain caused by scoliosis (pre-surgery)?
16. What are the psychological impacts (including on body image) of scoliosis and its treatment?
17. Would there be benefits to screening children/ young people for scoliosis? How could this be done?
18. When and how does scoliosis affect other parts of the body to cause additional symptoms?
19. How is scoliosis linked to other conditions (e.g. osteoporosis, connective tissue disorders, arthritis)? What impact do those conditions have on progression and vice versa? What are the implications for treatment and screening?
20. When is surgery best for different types of scoliosis, and what factors influence its success?
21. Is physiotherapy cost effective in the treatment of scoliosis, in terms of reducing other NHS service use/ future complications?
22. What are the best ways to care for people with scoliosis in the long-term, after surgery?
23. What triggers relatively mild scoliosis to worsen rapidly?
24. When and how often is repeat surgery for scoliosis required in later life?
25. What are the best strategies for preventing scoliosis (combining physiotherapy, orthotics, alternative therapies, diet, and/or exercise)?
26. Does scoliosis affect life expectancy in adults?
27. What is the most effective type of exercise (e.g. yoga, pilates, Schroth method, Alexander Technique) for people with scoliosis?

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For full details of all of the questions identified by this PSP, please see the document below.