Priority 3 from the Scoliosis PSP

UNCERTAINTY: Could surgical procedures be improved to become less invasive, reduce scarring and increase flexibility? (JLA PSP Priority 3)
Overall ranking	3
JLA question ID	0059/3
Explanatory note	Not available for this PSP
Evidence	Previous related research studies - NIHR HSC. ApiFix system for adolescent idiopathic scoliosis. Birmingham: NIHR Horizon Scanning Centre (NIHR HSC). Horizon Scanning Review. 2013 Cao Y, Xiong W, Li F. Pedicle screw versus hybrid construct instrumentation in adolescent idiopathic scoliosis: meta-analysis of thoracic kyphosis. Spine 2014; 39(13): E800-E810 NICE guidance states has said that the MAGEC system should be considered for children aged 2 and over with scoliosis, who need surgery to correct their curved spine. Hospital teams may want to use the MAGEC system because it avoids the need for repeated surgery to lengthen the rods. Medical technologies guidance [MTG18], June 2014.
Health Research Classification System category	Musculoskeletal

Extra information provided by this PSP
Original uncertainty examples	Does vertebral body tethering work? ~ What surgical techniques are the safest? ~ Are there any advances in the correction of the severe deformity without compromising lung function? ~ Can surgical procedures be improved to reduce scarring. Is there any chance of laparoscopic techniques being developed? ~ Is it possible to develop treatments that don't limit the flexibility of the spine? (Putting metal rods along the spine greatly reduces flexibility, so would there be any way to avoid this?)

Extra information provided by this PSP

Original uncertainty examples

Does vertebral body tethering work? ~ What surgical techniques are the safest? ~ Are there any advances in the correction of the severe deformity without compromising lung function? ~ Can surgical procedures be improved to reduce scarring. Is there any chance of laparoscopic techniques being developed? ~ Is it possible to develop treatments that don't limit the flexibility of the spine? (Putting metal rods along the spine greatly reduces flexibility, so would there be any way to avoid this?)

PSP information
PSP unique ID	0059
PSP name	Scoliosis
Total number of uncertainties identified by this PSP.	54 (To see a full list of all uncertainties identified, please see the PSP final report held on the JLA website)
Date of priority setting workshop	4 November 2017