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The 2012 President's letter

Dear Colleagues

It is a great honour for me to be the 6th President of SOSORT. I have been a member of our association since the first conference in Barcelona. This membership gave me the opportunity to meet clinicians, scientists and patients whose contribution to the field of Conservative Treatment of Scoliosis and basic science has been outstanding. SOSORT meetings have always been an opportunity to establish fruitful collaborations with colleagues working in other Countries, who share with me the enthusiasm for research and clinical applications in our orthopaedic field. The term "Orthopaedics" comes from the ancient Greek, and it should not be forgotten that  “straighten a child” is the core of our work.

Being the President of SOSORT is also a challenging task. Conservative treatment is nowadays facing a renascence in orthopaedics research, while its clinical applications remain limited. Our society might play an important role in filling this gap. Technical and methodological advances in physiotherapy and bracing are enormous, but not largely diffused. This is probably the reason for the success of the 2nd SOSORT Educational Course in Milan. Training in conservative treatments varies greatly from country to country, and sometimes is not provided at all. SOSORT might lead the process of creating standard training programmes.

The next annual SOSORT meeting in Chicago will continue to be a forum for dissemination of the latest scientific advances in the field and for open and in depth discussion among participants.

Our Scoliosis journal, has contributed to increase our reputation and visibility by publishing clinically relevant research and development in conservative treatment. I will do my best to promote its success and dissemination in the scientific community.

I am grateful to my predecessors in this role for the energy and time they devoted to the growth of SOSORT, and hope I shall be able to lead the society with the same wisdom, competence and enthusiasm as they did.

I am aware of the complexity of my task as President of our society, but I feel confident that the SOSORT Board, Committees and Members will support me with their knowledge, expertise and motivation.

Sincerely,

Jean Claude de Mauroy de Curière de Castelnau, MD,

President of SOSORT


The 2011 President's letter

A FEE for SOSORT

Dear members of SOSORT, dear colleagues,

Manuel Rigo, Theodoros B Grivas, Tomasz Kotwicki, Toru Maruyama: you can imagine what an honour it is for me to become President of this new, but already most distinguished Society, after these amazing doctors and, most of all, wonderful men. They created, as Founders (together with JP O’Brien, HR Weiss, and myself), the Society; they served as Presidents and Board members; they remain in the Consulting Board to help, and audit SOSORT, our international Society On Scoliosis Orthopaedic and Rehabilitation Treatment. But, primarily, while directly driving their own patients through the path of disease to find the best possible solutions for them, they have been able to find a way to indirectly help many, many more patients through SOSORT, and the scientific strength the Society is finally giving, after many years of absence, to the Scoliosis Orthopaedic and Rehabilitation Treatment. My biggest privilege and task is to try and follow these efforts, and maintain high the vital flame of our Society.

The Society is steadily growing. Like a baby, after the first, cautious steps, SOSORT is now strengthening and new, fresh blood, is arriving. Hopefully, not too much time will pass before these new friends will give much more scientific strength to research in the field than what the Founders have ever been able to do: but this is what we hope, and one of the main reasons why the Society has been founded: to coagulate these forces, to create the fertile basic ground from which a new and better knowledge can grow in this underdeveloped, and for a long time almost ignored area of research on scoliosis treatment.

And now, it is time to find straight, and good paths toward the future. The last Meeting in Barcelona clearly showed some of the old, as well of the new challenges we are going to face, and I will try to focus my Presidency on three key words, synthesized in an acronym, FEE: I have listed them in the order of the acronym, not of the priority:
• Fair-play: we are definitively different. We grew up in a world that was gradually forgetting research on conservative treatment, and where consequently a forum to compare each other did not exist; we developed somehow isolated, in a few mainly (but not only) European groups; as a consequence, we are in many respects very different from one another, either for braces used or for exercises proposed. But we also have a lot of commonalities, as we discovered and enlightened in these years: the treatment tools (but not how they are applied and developed), the team approach, the care of patients, the total commitment to their health, and to reduce their impairment and disability due to disease and/or therapy. While we began to contaminate each other, being also strong believers in what we do, we obviously continued to fight for our ideas. And this is correct, because new and better treatments for our patients can grow only from a good and strong comparison of theories and techniques. But, like in any other game, fair-play is the key: let’s fight “for” what we do, and not “against” what others do. This is a challenge SOSORT is already facing. And the Board has to be the referee to avoid unfair players to contaminate and disperse the good we are doing.
• Evidence: SOSORT is born to develop and strengthen evidence on scoliosis conservative treatment, either in favor or against our practices. After some years, we can say today that we have at least some evidence to rely on, but we can also admit that we have a long way still to run. First of all, we need to find the means to reach the best possible evidence. In bracing, the partial failure of the well-financed and well-organized US randomized controlled trial (RCT) – it has been converted into an observational controlled trial – joined with the total failure of the Dutch study, as well presumably of others previously attempted we are not aware of, clearly tells us something: RCTs are really difficult in a field where parents want the best treatment (or, at least, a treatment) for their children. An RCT has been produced on SpineCor, but on very few patients with low degree curves; perhaps RCTs will be started on exercises, since it could easily be done in countries where exercises are not used at all, due to the so-called “exercise-dogma” that continues to be claimed against their usefulness. But, evidence can be gathered also through other designs, such as good observational prospective studies, mainly if coming from clinical databases and/or registries. We have to find our way toward evidence; but in any case we have to deeply fight for evidence, strong evidence, because this is the only road to the future. This is a task to be continuously maintained, and SOSORT will do, while trying to find the best methodological approach to evidence in our field.
• Ethics: while the pendulum apparently is coming back, and conservative treatment for scoliosis seems to gain some more strength, it is also time to be very careful. We must be ethical in the approach to patients, in the selection of patients to be treated, in the conduction of treatments. We have to fight for teams, including all the people who are interested: surgeons, conservative physicians, orthotists, physiotherapists, patients and families. Without a team, we lose the battle: and we cannot sustain the approaches based on single professionals. Moreover, there are people around the world that are making money with caricatures of conservative treatments: insoles or dental treatments to correct scoliosis, therapies sold through Internet without even knowing the patient, non-sense exercises and non-sense braces. This is not ethical: while remaining open to new ideas if developed through formal (and ethical) researches, SOSORT have to start fiercely fighting for ethics in the approach to patients. Along with the Board we will continue, trying to tackle this issue.

The term FEE underlines another concept. We must pay, in the sense that we must serve our Society, to make it grow even more, because our patients and the conservative world of scoliosis treatment deserve it. Let’s pay by making research, let’s pay by remaining members, let’s pay by participating in the Meetings, let’s pay by serving the Society in the various Committees, in the Board, and eventually becoming Presidents. In doing this we will receive back much more: knowledge, science, advocacy (through the policy of research, the only one valid in the world),  wisdom for our patients. And friendship. At least, through my own experience; and I will fight to maintain this unique atmosphere of respect and alliance that now exist in the Society.

We are going to Milan for the next SOSORT Meeting, and you will soon have some news on that. Chicago 2013 and Wiesbaden 2014 were exciting venues that we have already attended. This Scoliosis Journal is growing, our Newsletter is a strength, and the Web Site is developing very well. The new Guidelines will soon be published, and other Consensuses are on the way. The relationships with the other Scientific Societies of the field, SRS (Scoliosis Research Society) and IRSSD (International Research Society on Spinal Deformities), are steadily growing. The Presidential Line will continue going to France and Lyon, with Jean Claude de Mauroy ready to face next year. SOSORT is slowly, but constantly growing.

Dear members, dear colleagues, we have gradually showed ourselves to the world in these years, and we will be looked to even more in the next years; there is  only one way, the way of any scientific society: Fair and Ethical research for Evidence (FEE).


Stefano Negrini
President of SOSORT

 


 

The 2010 President's letter

The SOSORT’s 7th annual meeting was successfully held in Montreal. Scientists, physical medicine and rehabilitation doctors, spinal surgeons, physiotherapists, psychologists, CPOs and patients from 17 countries all over the world presented and discussed about conservative management and basic research of spinal deformities. Next year the SOSORT’s annual meeting will be held on May 19th to 21st in Barcelona, where SOSORT was founded in 2004. This meeting will be a great opportunity for us to come in contact with new development as well as to reflect on what we had made in these 7 years.

Looking forward to seeing all of you in Barcelona.

The official journal of SOSORT, “Scoliosis” first published in 2006. Its high impact factor and fast publishing process have attracted many authors, and its open access policy allows the readers to access and extract articles with ease. I am convinced of the steady growth of the journal.

Several SOSORT multicenter studies including two brace studies are ongoing or ready to start. One is regarding the corrective power of the brace in the short-term and the other is RCT of the brace treatment. I hope many researchers will participate in the studies and we can demonstrate the effectiveness of the brace treatment.

The Clinical and Consensus Committee is publishing the nomenclature of spinal deformities, in which the knowledge of specialists from all over the world is condensed.

The Scientific and Research Committee is announcing a project titled: “SOSORT Supports Research”. This project attempts to assistant clinicians, especially physiotherapists, in developing research ideas and obtaining grant money to get them started. You can find an announcement of this important project in the SOSORT Newsletter.

Other many SOSORT committees including the Newsletter Committee and the Web-site Committee have been hard at work moving this organization forward. If you are interested to help shape the future of SOSORT by volunteering for a committee, please contact us.

I hope all of us can help our patients with our best conservative management.

Sincerely yours,

Toru Maruyama

 


2010 - C. Rivard

7th annual meeting of SOSORT Montreal After a successful meeting, the Montreal Scoliosis Research Group is trying to develop for the international visitors, an unforgettable meeting. Over the last 30 years, Montreal has been recognized for research on scoliosis. About 16 M.D, 24 PhD and more than 40 others professionals concentrated their research on all types of scoliosis, from congenital scoliosis caused by rare syndrome.

 

Good news, the program of the 7th annual meeting of SOSORT is almost finished. We received 78 abstracts and most of them, after an evaluation by 12 different peoples, have been accepted.

We will cover many different topics, like school screening, molecular biology, surface topography, radiology, basic science, biomechanics, physiotherapy, posture, quality of life, dynamic bracing, night time bracing and rigid bracing.

Our guest speaker, Dr Lawrence Lenke, will lecture us twice, once in the educational session Chaired by Dr Manuel Rigo and once more as SRS President elect.

As usual, we will have our consensus session presented by Dr Theodoros B. Grivas, our educational session chaired by Dr Manuel Rigo and our presidential addres by Dr Tomasz Kotwicki. Final Program

 With the help of the professional from Sainte-Justine Hospital (Johanne Charron, Christine Larue and Jean-François Hébert) we got a special agreement with the “Grand Plaza Hotel” on Sherbrooke street, at 139.00$ CAN per night. It’s a quite special rate.

In summary, we hope that you will join us in Montreal to help us to demonstrate that conservative treatment of scoliosis still have an important role now and for the future.

Charles H. Rivard

 


 

The 2008 President's letter

Dear colleagues,

I would like to express my gratitude to all SOSORT members for entrusting me with the position of the president of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT) for 2008.
Since its earliest steps after its Founding meeting, in Barcelona, January 23 - 24 , 2004, SOSORT has developed to a vibrant society. The founding aim of uniting specialists in orthopaedics and/or rehabilitation, as well as physiotherapists and other medical professionals dealing with spinal disorders, is now realized. Patients and their families are also welcome to cooperate with SOSORT.

To date the Society has organized five successful meetings, during which its status has been formulated and a number of committees have emerged. It has today its own Medline-indexed/tracked scientific journal, named Scoliosis, while its first Instructional Course Lecture (ICL) Book has been published. Moreover, a number of consensus papers have been discussed and published in Scoliosis journal.
The above mentioned activities of SOSORT have as their ultimate goal the promotion of the important idea of proper conservative treatment of scoliosis. SOSORT vision is to improve and further develop the conservative treatment, which is at any rate necessary when indicated, and which was in some way over the last decades disregarded for the favour of surgery.

It is proper to note in this communication that the philosophy of the majority of our members regarding the prevention of the deformity is pro school screening. The incidence/prevalence of surgery can significantly be diminished where conservative treatment is available at a high standard and it has also been documented and is generally accepted that bracing does alter the natural history of idiopathic scoliosis. All asymmetric children, therefore, who will be entitled to develop scoliosis will miss the opportunity to be picked up and will probably be discovered too late, when surgery will be the only treatment option. As expected, the outcome will be particularly worse in poor societies. Therefore, in explaining the role of school screening, it must also be clearly understood that its cost must be the direct cost of performance of the actual screening program and not the subsequent expenditures of follow-up, radiographs and other modalities described in the current literature. The negative and disappointing impact of discontinuation of scoliosis school screening has also been documented in the literature. Subsequently SOSORT publications in Scoliosis and in other PupMed journals describe recommendations for improvement of school screening procedure.

A major achievement of the society was the establishment of active cooperation with other relevant Societies, some with slightly different treatment-wise orientation, but all with the common aim of providing proper care to our deformed patients. Another encouraging fact is that, although SOSORT emerged from Western European settings, it has spread internationally to include many countries worldwide up to this moment. This was evident in our previous 2008 Athens meeting, where scientific papers and lectures from delegates coming from 21 countries were presented.

As for our future plans, the Lyon meeting, due in May 2009, is expected to be a new milestone in SOSORT educational, scientific, research and further activities. The flawless organization of this meeting by its Chairman Jean-Claude de Mauroy, a hint of which is already available on the meeting website, is anticipated to be successful and fully conforming to our expectations.
Looking forward to seeing you all soon in the beautiful city of Lyon next spring.

Kind regards,

Dr. Theodoros B. Grivas, MD, PhD
SOSORT 2008 President


 

The 2007 President's letter

Dear Colleagues and patients,

A new society has been born called 'International Society on Scoliosis Orthopaedic and Rehabilitation Treatment', SOSORT. We met for the first time in Barcelona on January 2004 during the first International Conference on Conservative Management of Spinal Deformities'. The interest towards the different approaches from multidisciplinary teams working in this field prompted us to make a joint effort to form a 'study group' for a consensus meeting, which was successfully organized by Stefano Negrini in Milan, January 2005. Three important consensus papers were developed which are going to be published in the new 'scoliosisjournal.com', about physiotherapy, bracing and objectives of the treatment, in other words, why we treat?. Also a paper on guidelines is already published in 'scoliosisjournal'. This is the official journal of the society and its editor-in-chief is our colleague and friend Hans Rudolf Weiss, from Bad Sobernheim, Germany.

The first meeting of this newly established scientific society was held in Poznan, Poland April 2006. Tomasz Kotwicki and Jaced Durmala did exceedingly well. I liked very much the way Tomasz and Jacek invited us to participate in the meeting: 'The problem of progressive spinal curvatures in children and adolescents remains unsolved. The immense progress of basic and clinical science has failed to protect our patients from this chronic and disabling condition. With the foundation of SOSORT the professionals dealing with conservative management of idiopathic scoliosis: physiotherapists, physicians, orthotists and scientists have a common forum to exchange ideas and improve the quality of patient care. We cannot prevent a scoliotic curve appearing but we have to be able to stop its progression'. This is so true.

Although there is increasing evidence that conservative management works to prevent progression of the curvature and health deterioration in patients with spinal deformities, the surgical approach has been gaining more and more power during the last two decades becoming the 'gold standard', while conservative treatment has been loosing its popularity and credibility, due in most cases to false claims for unproven methods. Thus, in many countries, many colleagues, mainly orthopaedic surgeons, are convinced that according to evidence based medicine surgery alone should be ethically proposed as an effective alternative for scoliotic patients. The development of new techniques and instrumentation produced perhaps too optimistic an expectation, forcing too many people to undergo unnecessary spinal fusion, with all its short term and unpredictable long term risks. However, an indepth revision of the international literature cannot clearly demonstrate that spinal fusion is able to improve health, in terms of quality of life for those patients undergoing surgery during the adolescent growth period. Whilst we cannot predict future trends, it seems that, as happened after the two decades of crazy development and overuse of bracing in the past , surgery could progressively lose its popularity. Obviously scoliosis surgery has its place, which is not discussed here, as also has conservative management, which includes specific exercises. The key points are realistic expectations and sound medical principles in order to avoid over-treatment. It is also necessary to offer lifelong care and support, as we can not cure ? in order to restore personal health following an 'illness'-. However, scoliosis is not an illness by itself, thus treatment success cannot be defined solely by a straightened spine. After years of clinical we can all recognize ( I apologise for this simplification) two main groups of scoliosis sufferers, those who cope well and those who do not. In both groups we can find surgically and non-surgically treated patients, people with mild (sometime really minor curvatures) and those with moderate to severe scoliosis. Thus it seems that there is not a unique alternative to guarantee a health life. The multidisciplinary approach is not just a necessity but also a patient rights. There is an impressive task in front of us. We should be able to select those patients who are able to live without an operation or, in other words, those patients who will not benefit from a risky operation, compared to conservative care. We should be able to select those non-surgically treated patients doing badly, but who could be even worse after a risky operation, and do our best to help them. Finally we should be able to select those patients doing badly, but for whom an operation would change significantly their situation, thus allowing them to improve. Let us work together to improve our competence.

I wish to be realistic. Many societies start full of good intentions. We must work tireless, with humility, with humanity, and seek a balance between the scientific and the empirical approach, in order to give the best care to the patients. Conservative care, is of course, far from perfect. Some people offer alternatives which are at best totally inefficient and at worse even dangerous. Sometimes this happens apparently supported by 'scientific studies'. Again here, I would like to remind you that science is neutral by itself, but it is people who can misuse it, for their personal interest. It is impossible to totally avoid these people joining our society, but we will try to prevent this as much as possible. I invite everyone, patients and their families included, who deal with conservative management and share this type of approach, to join us. Please give your support to help us do our best.

Sincerely yours,

Manuel Rigo M.D.
President of SOSORT


 


 

2013

Dear Colleagues

It is a great honour for me to be the 6th President of the SOSORT. I have been a member of our association since the first conference in Barcelona. This membership gave me the opportunity to meet clinicians, scientists and patients whose contribution to the field of Conservative Treatment of Scoliosis and basic science has been outstanding. SOSORT meetings have always been an opportunity to establish fruitful collaborations with colleagues working in other Countries, who share with me the enthusiasm for research and clinical applications in our orthopaedic field. I don’t forget that the term "Orthopaedics" comes from the ancient Greek, and “straighten a child” is the core of our work.

Being the President of SOSORT is also a challenging task. Conservative treatment is nowadays facing a renascence in orthopaedics research, while its clinical applications remain limited. Our society might play an important role in filling this gap. Technical and methodological advances in physiotherapy and bracing are enormous, but not largely diffused. This is probably the reason for the success of the 2nd SOSORT Educational Course in Milan. Training in conservative treatments varies greatly from Country to Country, and sometimes is not provided at all. SOSORT might lead the process of creating standard training programs.

The next annual SOSORT meeting in Chicago will continue to be a forum for dissemination of latest scientific advances in the field and for open and in depth discussion among participants.

Our journal, Scoliosis journal, has contributed to increase our reputation and visibility by publishing clinically relevant research and development in conservative treatment. I will do my best to promote its success and dissemination in the scientific community.

I am grateful to my predecessors in this role for the energy and time they devoted to the growth of SOSORT, and hope I shall be able to lead the society with the same wisdom, competence and enthusiasm as they did.

I am aware of the complexity of my task as President of our society, but I feel confident that SOSORT Board, Committees and Members will support me with their knowledge, expertise and motivation.

Sincerely,

Jean Claude de Mauroy de Curière de Castelnau, MD,

President of SOSORT