PTOTSystematic ReviewEuropean journal of physical and rehabilitation medicine2023

The impact of pregnancy on women with adolescent idiopathic scoliosis: a scoping review.

Jean Theroux, Benjamin T Brown, Rosemary Marchese and 4 others

PMID 37746783

WHAT IT FOUND

Pregnancy does not cause average curve progression in treated adolescent idiopathic scoliosis, but some women progress regardless.

Back pain is common but rarely severe. Surgical patients face higher caesarean rates and difficult epidurals, though analgesia is usually eventually achieved.

Key findings

01On average, pregnancy does not lead to clinically significant curve progression in AIS patients managed with bracing or surgery, though some individuals do progress.

02More attempts are often needed to achieve epidural analgesia in AIS patients, particularly those with spinal instrumentation, but success is eventually achieved in most cases.

03Caesarean section rates are higher in surgically managed AIS patients compared to conservatively managed patients, although reasons for this choice are often not disclosed.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTs

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What it does not show

Most included studies were retrospective or case reports, and only 20 were published after 2010. Data on curve progression in untreated patients is limited to studies published before 1988. The review did not assess the risk of bias or quality of the included studies. Many studies failed to report the specific reasons for caesarean sections, making it difficult to attribute the higher rate solely to scoliosis. Heterogeneity in management strategies means findings may not apply to modern bracing or surgical techniques.

Declared interests

No specific funding sources or conflicts of interest are declared in the provided text.

The easy way to misread this

Do not assume pregnancy is safe for all curve types or that progression never occurs. While average progression is not clinically significant in treated patients, some individuals do progress. Additionally, do not interpret the higher caesarean rate in surgical patients as a direct physiological necessity, as the reasons for these interventions were often not disclosed and may include obstetrician preference.

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