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HT17-04 scoliosis

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11/22/2019

Based on available studies, it cannot be estimated whether stereography for radiation-free video scan can replace x-ray in the monitoring of idiopathic scoliosis. Further studies are needed.

Idiopathic scoliosis is a curvature of the spine that develops during growth. The spine is twisted in itself and bends more and more to the side. From a certain angle of curvature it is processed. As a technical assistance for frequent back examinations, there is also an irradiation-free method with X-ray: Videorasterstereographie. In the name IQWiG Scientists from the University of Duisburg-Essen have now received a health technology assessment (Health Technology Assessment. HTA) examines whether video stereoscopic stereoscopy is suitable for X-ray replacement below.

HTAReport under IQWiGThe ThemenCheck Medizin method concludes that based on the available studies, it cannot be estimated whether video stereoscopic stereography is an equivalent substitute for X-rays. For patients with idiopathic scoliosis, there is a great benefit of radiation-free testing. Therefore, open-ended questions about the medical well-being of the study should be answered by appropriate studies.

Spine curvature affects 1 to 2 in 100 children

Idiopathic scoliosis affects 1 to 2 in every 100 children and adolescents, girls more often than boys. Depending on the location and degree of curvature, adults may influence, for example, low back pain or decreased lung function. Already in childhood and adolescence, a specific body image can cause psychosocial problems. There are several treatment options, depending on the degree of curvature and the degree of bone growth. They range from physiotherapy to corsets to surgery where the spine is raised and secured with metal rods or screws. Especially for children and adolescents, prolonged therapy and possibly wearing a corset can be a great psychological and social burden.

Because frequent x-rays can cause cancer, it is important to look for fewer diagnostic options below.

The measured values ​​of the two methods do not match well

Scientists could not identify a study that would directly compare which of the two imaging procedures – X-ray or video stereoscopy – would lead to more reliable monitoring and then better treatment results. The study resulted in only 4 studies that showed that the curvature results of the spine did not match well between video stereoscopic and X-ray. However, it remains unclear whether the discrepancies are so large that they lead to wrong decisions, for example, treatment starts too late.

No studies were found in which the cost-benefit ratio was examined. Total cost for video stereoscopic stereography ranges from € 150 to € 200, of which the patient has to pay between € 105 and € 146. The total cost of the X-ray is just under € 70, fully covered by compulsory health insurance.

Appropriate studies required to answer open-ended questions

Based on the available studies, it cannot be said that video stereoscopic stereography at the follow-up examination is an equivalent substitute for X-ray examinations. For patients with idiopathic scoliosis, however, it would be beneficial if the X-ray could be replaced with an irradiation-free alternative. Therefore, open-ended questions about the medical well-being of the study should be answered by appropriate studies.

Citizens ask, scientists answer

A theme for the present
HTAThe report goes to the citizen's suggestion on the topic of drug medicine screening
IQWiG back: From 2016 everyone can ask their questions online
Science (www.themencheck-medizin.iqwig.de). After selecting from
up to five topics a year, answer this in the form of a
so-called HTAThe report says: This is not just a medical benefit
medical procedure, but also economic,
ethical, social, legal and organizational implications.