21st July 2006
By Stella Shaffer
The University of Iowa will take a look at screening programs for a disorder once known as "curvature of the spine." In cases of scoliosis the spinal bones grow improperly, curving the backbone from side to side. In a few cases surgery's required to correct the condition, but most aren't serious enough to need treatment, or can be corrected with spinal braces.
Doctor Stuart Weinstein says they're going to study whether that bracing does any good. Right now about 22 states require students to be screened for scoliosis, but he says looking for a condition is based on having an effective treatment for it. "Right now, we don't know if bracing is effective treatment," he says. If it works, Weinstein says all fifty states should be screening for it.
If not, he says the laws that mandate screening should be eliminated in those states that require it now. If they are effective, doctors should be "diligent" in their recommendation that children get braces and wear them, and if they're not effective, he says we should quit making kids and their families go through lots of costly treatment and doctor visits.
If the study finds that bracing has no effect on a slight spinal curve, Weinstein says it'll help steer treatment in the future, both for patients who have a mild case, and for those with more severe deformity that can threaten to cause disability. Many curves won't get any worse, or won't get much worse and will not affect the child's life. A certain number will get bad enough to require surgery.
If bracing turns out to prove effective, the study group will recommend that it be done in all fifty states. If not, they'll look at which patients progress and need surgery. Even those patients can look forward to more effective and less burdensome treatment than the ordeal they once went through. He says rarely are they put into a plaster body cast any more, and casts and braces hardly ever are required after a patient undergoes surgery to correct scoliosis. Weinstein says, "the technology as far as surgery has changed dramatically over the years." He says if non-surgical treatment won't do much, it would save money for schools to skip the screening.
If bracing does work, he says screening should be done everywhere, and doctors should be diligent in prescribing braces and seeing that their young patients comply.