The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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  • Recent Comments

    Disappointing evidence for nonsurgical treatment of adult scoliosis

    According to researchers from the University of Rochester School of Medicine in New York, conservative care for this abnormal sideways curving of the spine is poorly supported by scientific evidence.”

    First, the details.

    • A literature search identified studies in adult or degenerative and scoliosis.
    • Secondary search terms included bracing, casting, physical therapy, chiropractic, and injections for treatment.
    • The procedures (methodology) of the studies were graded, and the evidence was classified into one of 5 levels based on study types.

    Assigning levels provides a shorthand way of ranking the nature (not the quality) of the evidence being used. Level I is best, while Level V is the lowest level of evidence.

    And, the results.

    Injections as part of the conservative treatment of adult deformity are supported by Level III evidence.

    • Level III evidence includes studies where there is no attempt to randomly assign treatment.
    • Examples include reports about the history of individual patients or groups of patients.

    Chiropractic care, physical therapy, and bracing are supported by Level IV evidence.

    • Level IV evidence is based on the opinion of respected authorities or that of expert committees as indicated in published consensus conferences or guidelines.
    • That’s nice but in the absence of the results from well-designed studies, this level of evidence in anecdotal.

    The bottom line?
    The authors conclude, “Conservative care in general may be a helpful option in the care of adult deformity, but evidence for this is lacking. Unfortunately, no treatment option within conservative care has support within the literature as a preferred solution.”

    Further discussion about levels of evidence is here. And background information on adult scoliosis is here at SpineUniverse.

    10/5/07 14:42 JR

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