Priority 20 from the Scoliosis PSP

UNCERTAINTY: When is surgery best for different types of scoliosis, and what factors influence its success? (JLA PSP Priority 20)
Overall ranking	20
JLA question ID	0059/20
Explanatory note	Not available for this PSP
Evidence	Previous related research studies - Daniel KL Cheuk, Virginia Wong, Elizabeth Wraige, Peter Baxter & Ashley Cole (2015) Surgery for scoliosis in Duchenne muscular dystrophy. Cochrane Neuromuscular Group, The Cochrane Library. Gerian Huitema, Paul C Willems, Lodewijk van Rhijn, Jos Kleijnen & Christopher I Shaffrey (2014) Anterior versus posterior spinal correction and fusion for adolescent idiopathic scoliosis. Cochrane Back and Neck Group, The Cochrane Library. Ledonio CG, Polly DW, Crawford CH, Duval S, Smith JS, Buchowski JM, Yson SC, Larson AN, Sembrano JN, Santos ER. Adult degenerative scoliosis surgical outcomes: a systematic review and meta-analysis. Spine Deformity 2013; 1(4): 248-258 Sardar ZM, Ouellet JA, Fischer DJ, Skelly AC. Outcomes in adult scoliosis patients who undergo spinal fusion stopping at L5 compared with extension to the sacrum. Evidence-Based Spine-Care Journal 2013; 4(2): 96-104 Surgical correction of scoliosis in children with spastic quadriplegia: benefits, adverse effects, and patient selection. Legg J1, Davies E2, Raich AL3, Dettori JR3, Sherry N3. Evid Based Spine Care J. 2014 Apr;5(1):38-51. Orthop Traumatol Surg Res. 2015 Feb;101(1 Suppl):S109-18. doi: 10.1016/j.otsr.2014.06.032. Epub 2015 Jan 23. Early-onset scoliosis: current treatment. Cunin V1.
Health Research Classification System category	Musculoskeletal

Extra information provided by this PSP
Original uncertainty examples	What are the best clinical indicators for when to refer to a spinal surgeon? ~ Wheel chair dependent children are at risk of developing progressive and painful scoliosis. When is the best time to operate? Early before the curve is severe or late when a severe curve is already established? ~ Is spinal correction more complicated in a patient with EDS? ~ How can I as a parent be 100% sure that spinal fusion surgery is the only option ~ What's the evidence for surgery for curvatures of the spine in adults?

Extra information provided by this PSP

Original uncertainty examples

What are the best clinical indicators for when to refer to a spinal surgeon? ~ Wheel chair dependent children are at risk of developing progressive and painful scoliosis. When is the best time to operate? Early before the curve is severe or late when a severe curve is already established? ~ Is spinal correction more complicated in a patient with EDS? ~ How can I as a parent be 100% sure that spinal fusion surgery is the only option ~ What's the evidence for surgery for curvatures of the spine in adults?

PSP information
PSP unique ID	0059
PSP name	Scoliosis
Total number of uncertainties identified by this PSP.	54 (To see a full list of all uncertainties identified, please see the PSP final report held on the JLA website)
Date of priority setting workshop	4 November 2017