The list of top 21 items of most importance when considering scoliosis treatment outcomes by SOSORT highlights a very commonly lost concept.

Idiopathic Scoliosis patients are people. They aren't floating spines that come wandering into doctor's offices. Where is an honest to goodness real live person attached to that spine.

The orthopedic community has become so soley focused on cobbs angle as the only unit of measure for scoliosis that it is completely understating the majority of the disease and the most important aspect of the disease......the patient.

Cobb's angle is simpily put nothing more than measurement of the gross lateral flexion of the curvature. Nothing more, nothing less. I doesn't provide any knowledge in terms of rotation, level arm biomechanics, pain, quality of life, organic health measures such as pulmonary or cardiovascular health; nothing.

It is a quick and dirty method of describing when a different treatmetn method should be applied (observation, bracing, surgery)

It understates the complexity of the disease and undermines the importance of the patient. Perhaps this is why SOSORT felt it appropriate to list aesthetics, quality of life, psychological well-being, disability, back pain, rib hump, breathing function, curve progression in adulthood, needs for further treatment in adulthood, knowledge/understanding of scoliosis in general and their specific growth pattern, and balance ahead of Cobb's angle in importance of scoliosis treatment goals.

Just one man's opinion (Supported by some of the foremost scoliosis experts in the world).

Thoughts?

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Looking at thousands of x-rays over the course of 12 years in clinical practice I have seen the spine design itself into some interesting configurations that often leave you scratching your head in disbelief. The scoliotic spine is a complex 3 dimensional deformity which can not be measured by a one dimensional x-ray. the lateral flexion component (cobb angle)is exactly that a component of a very complex biomechanical system yet the medical community insists on using it and only it as a reason to perform invasive procedures.