***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Study Design . A consecutive series of female patients with adolescent idiopathic scoliosis treated between 1968 and 1977 , either with distraction and fusion using Harrington rods ( n = 145 ) or with a brace ( n = 122 ) , were followed for at least 20 years after completion of the treatment . Objectives . To determine the long-term outcomes of childbearing and sexual life in women treated for adolescent idiopathic scoliosis , as compared with matched control subjects who did not have scoliosis . Summary of Background Data . The effect of pregnancy on curve progression is not established , and results are contradictory . Few reports exist on the social life ( marriage , childbearing , and sexual function ) of formerly treated individuals with scoliosis . Methods . In this study , 136 surgically treated women ( 94 % ) and 111 brace-treated women ( 91 % ) completed the Scoliosis Research Society (SRS)/MODEM ’s question naire concerning childbearing and sexual life as a part of an unbiased personal follow-up examination . Of these , 129 surgically treated and 105 brace-treated women also underwent a radiographic examination . The Cobb method was used to measure curve size in present and earlier examinations . An age-matched control group of 90 women was r and omly selected and subjected to the same examinations . Results . The mean age for all the groups was 40 years . Of the surgically treated and brace-treated women , 85 % were or had been married  , as compared with 82 % of the control women . In the total cohort , 628 pregnancies had occurred . No significant mean difference existed between the groups in the number of children born ( 1.8 for the surgically treated , 1.9 for the brace-treated , and 2 for the control women ) ( P = 0.25 ) . The patients in the brace-treated group had a significantly higher mean age at first pregnancy ( 28 years ) than the control subjects ( 25.9 years ) ( P = 0.011 ) , whereas the age for the surgically treated women ( 26.6 years ) did not differ significantly from that for the brace-treated women . There were no significant differences between the groups in rates for low back pain ( 35 % for the surgically treated , 43 % for the brace-treated , and 28 % for the control group ) or for cesarean section ( 19 % for the surgically treated , 14 % for the brace-treated , and 18 % for the control group ) during the first pregnancy . The rate of vacuum extraction s was higher in the surgically treated group ( 16 % ) than in thecontrol group ( 5 % ) ( P = 0.036 ) or the brace-treated group(8 % ) . Limitation of sexual function from the back was admitted by 33 % of the surgically treated , 28 % of the brace-treated , and 15 % of the control women : surgically treated vs control subjects ( P = 0.0042 ) , brace-treated vs control subjects ( P = 0.026 ) , and brace-treated vs surgically treated subjects ( P = 0.57 , a nonsignificant difference ) . These limitations were largely because of difficulties participating physically in activities or self-consciousness about appearance . Pain was a minor reason for limitation . There was no correlation between progression of the major or lumbar curve and number of pregnancies , or between curve progression and age at first pregnancy . Conclusions . Patients treated for adolescent idiopathic scoliosis appeared to function well with regard to marital status and number of children . The scoliotic curve did not seem to increase as a result of childbearing . Minor problems occurred during pregnancy and delivery . Some patients , however , experienced a slight negative effect in their sexual life AIM Bracing is considered to be effective in the treatment of adolescent idiopathic scoliosis . The concept prevailing today includes an asymmetrical construction , mainly using a mechanical three-point system . We developed the new Sforzesco brace , based on the SPoRT concept ( Symmetric , Patient-oriented , Rigid , Three-dimensional , active ) . The aim of this study is to verify the results of this concept and brace , compared to three-point classical systems . METHODS We performed a prospect i ve , pair-controlled study . It was possible to match 15 patients , out of the first 18 consecutively treated with the Sforzesco brace ( Group SPoRT ) , with previous patients treated with the Lyon brace ( Group LY ) . SPoRT included 14.2+/-1.7 year old patients , with 47+/-7 degrees Cobb worst curves , and 11+/-4 degrees Bunnell ; LY included 13.6+/-1.6 year old patients , with 43+/-7 degrees Cobb and 12+/-5 degrees Bunnell . The brace had to be worn 23 h per day and patients were evaluated after 6 months both clinical ly and radiographically ( without the brace ) . Appropriate statistics were used . RESULTS At the baseline there were slight differences between the groups , with SPoRT worse than LY . All radiographic and clinical parameters decreased significantly with treatment in both groups , apart from thoracic Cobb degrees in LY . SPoRT had better results than LY ( P<0.05 ) radiographically ( worst curve -10+/-5 degrees vs -5+/-7 degrees , all curves -8+/-7 degrees vs -6+/-7 degrees ) , for sagittal profile ( distance from plumbline : T12 -6+/-9 mm vs + 2+/-8 and L3 -7+/-12 vs 0+/-10 ) and aesthetics of the shoulders ( 9 improved and 6 unchanged vs 5 and 8) and waists ( 10 improved and 5 unchanged vs 5 and 8) . Finally , clinical results in terms of patient recovery were better in SPoRT than LY ( 12 improved and 3 unchanged vs 8 and 5 ) . CONCLUSION When a new treatment is introduced , it is not possible to wait years ( end of therapy ) before verifying its utility , and in scoliosis bracing a short term study already gives very important clues . This study confirms the immediate efficacy of brace treatment ( even in such high degree cases ) whatever the brace concept used , with only 2 ( out of 30 ) progressed curves . In SPoRT we had no progressions , and obtained a statistically significant 80 % better radiographic results than LY in the worst scoliosis curve , and 40 % in the average of all curves , as well as improved aesthetics and sagittal profile ( that is crucial in scoliosis bracing ) . The Sforzesco brace should be used , and the SPoRT concept explored in the long term to verify if the classical three-point system should be totally ( or partially ) ab and oned Background Studies investigating the outcome of conservative scoliosis treatment  differ widely with respect to the inclusion criteria used . This study has been performed to investigate the possibility to find useful inclusion criteria for future prospect i ve studies on physiotherapy ( PT ) . Material s and methods A PubMed search for outcome papers on PT was performed in order to detect study design s and inclusion criteria used . Results Real outcome papers ( start of treatment in immature sample s/end results after the end of growth ; controlled studies in adults with scoliosis with a follow-up of more than 5 years ) have not been found . Some papers investigated mid-term effects of exercises , most were retrospective , few prospect i ve and many included patient sample s with question able treatment indications . Conclusion There is no outcome paper on PT  in scoliosis with a patient sample at risk for being progressive in adults or in adolescents followed from premenarchial status until skeletal maturity . However , papers on bracing are more frequently found and bracing can be regarded as evidence -based in the conservative management and rehabilitation of idiopathic scoliosis in adolescents Abstract . No results on long-term outcome in terms of health-related quality of life ( HRQL ) have previously been presented for patients treated for adolescent idiopathic scoliosis . A consecutive series of patients with adolescent idiopathic scoliosis , treated between 1968 and 1977 before the age of 21 , either with distraction and fusion using Harrington rods [ surgical treatment group ( ST ) , n=156 ; 145 females and 11 males ] or with a brace [ brace treatment group ( BT ) , n=127 ; 122 females and 5 males ] were followed at least 20 years after completion of the treatment . Ninety-four percent of ST and 91 % of BT patients filled in a question naire comprising the SF-36 , Psychological General Well-Being Index ( PGWB ) , Oswestry Disability Back Pain Question naire , parts of SRS/MODEM 'S question naire and study -specific questions concerning the treatment , as a part of an unbiased personal follow-up examination including radiography and clinical examination . An age- and sex-matched control group of 100 persons was r and omly selected and subjected to the same examinations . The results showed no differences in terms of sociodemographic data between the groups . Both ST and BT patients had a slightly , but significantly , reduced physical function using the SF-36 subscales , SF-36/Physical Component Summary ( PCS ) score as well as the Oswestry Disability Back Pain Question naire compared to the controls . Neither the mental subscales and the Mental Component Summary ( MCS ) score of SF-36 nor the PGWB index showed any significant difference between the groups . Forty-nine percent of ST , 34 % of BT and 15 % of controls admitted limitation of social activities due to their back [ P<0.001 ST vs controls , P=0.0010 BT vs controls , and n.s . ( P=0.024 ) ST vs BT ] , mostly due to difficulties with physical participation in activities or self-consciousness about appearance . Pain was a minor reason for limitation . No correlation was found between the outcome scores and curve size after treatment , curve type , total treatment time or age at completed treatment .  Patients treated for adolescent idiopathic scoliosis were found to have approximately the same HRQL as the general population . A minority of the patients ( 4 % ) had a severely decreased psychological well-being , and a few ( 1.5 % ) were severely physically disabled due to the back Background Studies investigating the outcome of conservative scoliosis treatment  differ widely with respect to the inclusion criteria used [ 1 ] . While the application of the SRS criteria for studies on bracing seem useful , there are no inclusion criteria for the investigation of physiotherapy alone . This study has been performed to investigate the possibility of useful inclusion criteria for future prospect i ve studies on physiotherapy ( PT ) BACKGROUND CONTEXT Evidence demonstrating the biomechanical effects of the Hueter-Volkmann principle on vertebral body growth in spinal deformities is lacking . Bracing a scoliotic curve should , in theory , unload the growth plates on the concave side of the vertebral bodies near the curve 's apex . Growth stimulation , leading to structural remodeling of the vertebral bodies , on the curve 's concave side may explain the improvement or lack of curve progression , as measured by Cobb angles , reported with successful brace management of adolescent idiopathic scoliosis ( AIS ) . PURPOSE To determine whether brace treatment stimulated asymmetric chondrogenesis in the apical three vertebral bodies . STUDY DESIGN A prospect i ve cohort of patients with AIS receiving brace treatment were followed from the initiation of brace treatment until skeletal maturity . Patients were then retrospectively divided into those with and without radiographic progression . This post hoc analysis was included to determine risk factors for curve progression . PATIENT SAMPLE Forty-one skeletally immature patients with AIS meeting criteria for brace treatment were followed until skeletal maturity . All patients were treated with thoracolumbosacral orthotics ( TLSOs ) . OUTCOME MEASURES The positional derotation of the TLSO on the spine was measured by comparing the initial radiograph with the first radiograph in a brace . The long-term structural changes of the vertebral bodies were determined by comparing the initial and final radiographs . Differences in initial radiographic parameters between the groups of patients with AIS with and without curve progression indicated predictive factors for successful brace treatment . METHODS Initial radiographic measurements were compared with those observed in a brace and those observed at final follow-up . The same analysis was retrospectively repeated comparing patients with AIS with and without radiographic progression . RESULTS Cobb measurements ( p=.0001 ) and concave-to-convex height ratios of the apical three vertebral bodies improved when the brace was initially applied ( p=.0035 ) . Structural remodeling or a rotational correction of the apical three vertebral bodies was appreciated only in patients with flexible curves ( p=.01 ) . CONCLUSION Brace application results in immediate positional derotations of the spine in patients with AIS . These positional derotations were maintained only in patients with flexible curves , at final follow-up . Brace treatment was not recommended in patients whose curves did not correct at least 20 % in a TLSO A prospect i ve study was carried out of the incidence and natural history of adolescent idiopathic scoliosis in 26,947 students . Data were obtained on 1,122 students with idiopathic scoliosis . The incidence of idiopathic scoliosis was 4.5 per cent . The female-to-male ratio was 1.25:1.0 over-all , but the ratio varied directly with the severity of the curve -- that is , 1:1 for curves of 6 to 10 degrees , and 5.4:1 for curves of more than 20 degrees . Progression of the curve was determined by a two-year follow-up of 603 patients . Progression was observed in 6.8 per cent of the students and in 15.4 per cent of the skeletally immature girls with scoliosis of more 
    Output:
    
Short-term results of the surgical treatment of people with AIS demonstrate the ability of surgery to improve various outcome measures .
MAIN RESULTS We did not identify any evidence comparing surgical to non-surgical interventions  for AIS with severe curves of over 45 degrees .