Do the scoliosis treatment "ends" justify the scoliosis brace/ scoliosis surgery "means"?

"The ends justify the means" is a common statement in our everyday society and when applied to the greater or long-term good of the individual, organization, or humanity it is generally accepted. Unfortunately, this can not be said in regards to the current state of scoliosis treatment. For the last 3500 years of recorded human history (and the last 450 in particular) idiopathic scoliosis patients have been poked, stretched, cut, squashed, and even tied to various apparatuses and procedures in an attempt to alter the natural course of idiopathic scoliosis under the guise of "the ends justify the means".

Scoliosis brace treatment first appeared in recorded human history around 650AD and has taken virtually every form and approach the a human mind could conceive, yet when compared to the expected genetically predicted natural course of idiopathic scoliosis, the scoliosis brace treatment data shows absolutely NO effect. None! In addition, in 2007 Drs. Weinstein and Dorlan reviewed 15 comprehensive scoliosis brace studies (using virtually every kind of scoliosis brace on the market) and found that scoliosis surgery rates among the scoliosis brace study participants were exactly the same as the untreated idiopathic scoliosis patients. Finally, rat tail research being conducted at the University of Vermont is discovering that simulated scoliosis brace conditions on the rat tail (which is practically structurally identical to a human spine) actually makes the permanent deformity of the disc worse and probably increases the risk of curve progression in scoliosis adult patients.

Scoliosis surgery has been performed since 1865 and has changed both in procedure and intent since that time. The original scoliosis surgery was in hopes of halting progression of the curvature and that mindset held true all the way until the 1950's and 1960's when Paul Herrington introduced the "Herrington rod" scoliosis surgery. The pedicle screw system developed by Cotrel & Dubousset was the next (and still currently used) scoliosis surgery technique to be employed. While it allowed for much better correction of the idiopathic scoliosis deformity, it also came with a lot more complications and very poor long-term quality of life results. In fact, one study found that 40% of post scoliosis surgery treated patients were legally defined as "severely handicapped" only 16.9 years after the scoliosis surgery.

While both of these scoliosis treatment methodologies (scoliosis brace treatment and scoliosis surgery) are and were created with the best of intensions, it cannot be said that the means justify the end. In fact, a 50 year follow up study of untreated idiopathic scoliosis patient found they had a quality of life the exceeded the scoliosis surgery treated patients and one could only assume that the untreated idiopathic scoliosis patient's quality of life was at least equal to that of the scoliosis brace treated patients since scoliosis brace treatment doesn't seem to have any positive effect on idiopathic scoliosis anyway.

So where does that leave the idiopathic scoliosis patient in terms of scoliosis treatment? From my perspective, between a rock and a hard spot, but help is one the way. Scoliosis treatment is undergoing a revolution for the first time since scoliosis surgery was first performed. Early stage prognostic testing for idiopathic scoliosis is allowing us to determine which patients are at an elevated risk for severe scoliosis and which need extensive early stage scoliosis treatment to prevent the onset of a spinal deformity.