Scoliosis is a recognised musculoskeletal complication in individuals with Friedreich ataxia. Decisions about how to manage the spinal curve require careful consideration of the evidence, particularly regarding the choice between conservative and surgical approaches.
This protocol addresses Friedreich ataxia in the setting of scoliosis (spinal curve). The presence of progressive spinal deformity in these patients raises important management questions, and the available evidence points away from early surgical intervention as a first step.
The structured evidence-based approach favours conservative therapy over surgery for scoliosis in Friedreich ataxia. One component of conservative management involves a physical intervention used during the period of rapid skeletal growth in younger patients.
Full regimen, criteria, and clinical algorithm available via the link below.DOI: 10.1186/s13023-022-02568-3
We suggest surgery should not be used over conservative therapy for individuals with scoliosis and Friedreich ataxia.
Expert opinion suggests that conservative therapy, including the use of bracing during the time of rapid growth in children/adolescents (age 10 to 16 years), may assist in avoiding or delaying surgery.
People with Friedreich ataxia with a scoliosis > 40° may be considered appropriate for surgical correction.
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