Table 1.
Situation | Alternatives | Decision-making tools | Question Which strategy? |
AIS with a 25% risk of progression; consequence if it progresses: bracing until growth is complete | • Do nothing, periodic check-ups Specific physical exercises until growth is complete, in an attempt to prevent progression |
• scientific evidence (no proof for or against physical exercises as means of preventing progression) • advantages and disadvantages of each alternative |
• Physical exercises until growth is complete, in an attempt to prevent/delay bracing • Periodic check-ups, bracing only if scoliosis progresses |
AIS with a 60% risk of progression; consequence if it progresses: surgical correction | • Do nothing, periodic check-ups • Bracing until growth is complete |
• scientific evidence (proof of the efficacy of bracing, but not in all cases) • advantages and disadvantages of each alternative |
• Immediate bracing, in order to avoid surgical correction • Periodic check-ups, bracing only if scoliosis progresses • No bracing at all, periodic check-ups, surgical correction if scoliosis progresses |
School screening for AIS | • not to screen • to screen |
• Scientific evidence (absence of consensus): pros and cons | • not to screen • to screen |