Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis
Scoliosis refers to a three-dimensional deviation in the axis of the spine. Muscle imbalance is believed to play a role in scoliosis. Botulinum neurotoxin (BoNT) can reduce muscle overactivity and may have the potential to ameliorate spinal scoliosis. This study investigated the effectiveness of int...
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MDPI AG
2022-10-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/9/10/1505 |
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| author | Yu-Chi Su Yu-Ching Lin Pei-Chun Hsieh Chung-Lun Liao Yao-Hong Guo |
| author_facet | Yu-Chi Su Yu-Ching Lin Pei-Chun Hsieh Chung-Lun Liao Yao-Hong Guo |
| author_sort | Yu-Chi Su |
| collection | DOAJ |
| description | Scoliosis refers to a three-dimensional deviation in the axis of the spine. Muscle imbalance is believed to play a role in scoliosis. Botulinum neurotoxin (BoNT) can reduce muscle overactivity and may have the potential to ameliorate spinal scoliosis. This study investigated the effectiveness of intramuscular BoNT injection in vertebral curve correction and reviewed the possible influencing factors. PubMed, Medline, Cochrane Central Register of Controlled Trials, Web of Science, Airiti Library, and Index of the Taiwan Periodical Literature System databases were searched from inception until 7 September 2022 for eligible studies. The main outcome was the change in Cobb angle after BoNT application. Subgroup analysis was conducted according to differences in study designs, etiology of scoliosis, and methods used for target muscle selection. We enrolled three studies including 31 participants aged between 2 and 18 years. The meta-analysis revealed no significant reduction in the Cobb angle after BoNT injection (standardized mean difference, −0.783, 95% CI, −2.142 to 0.576). Study designs (<i>p</i> = 0.011) and methods used for target muscle selection (<i>p</i> = 0.017) but not etiology of scoliosis (<i>p</i> = 0.997) reached statistical significance between subgroups. In conclusion, the current meta-analysis does not support the application of BoNT in children and adolescents with scoliosis. However, a decisive conclusion could not be made due to high between-study heterogeneity and small sample size. More randomized controlled trials with appropriate target muscle selection and standard outcome measurement should be conducted to examine the efficacy of botulinum neurotoxin in treating scoliosis. INPLASY ID: INPLASY202290031. |
| first_indexed | 2024-03-09T20:27:42Z |
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| language | English |
| last_indexed | 2024-03-09T20:27:42Z |
| publishDate | 2022-10-01 |
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| record_format | Article |
| series | Children |
| spelling | doaj.art-f571074d05924a108aecf2fbeba0d53d2023-11-23T23:32:03ZengMDPI AGChildren2227-90672022-10-01910150510.3390/children9101505Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-AnalysisYu-Chi Su0Yu-Ching Lin1Pei-Chun Hsieh2Chung-Lun Liao3Yao-Hong Guo4Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70428, TaiwanDepartment of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70428, TaiwanDepartment of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70428, TaiwanSchool of Medicine, College of Medicine, National Cheng Kung University, Tainan City 70101, TaiwanDepartment of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan City 70428, TaiwanScoliosis refers to a three-dimensional deviation in the axis of the spine. Muscle imbalance is believed to play a role in scoliosis. Botulinum neurotoxin (BoNT) can reduce muscle overactivity and may have the potential to ameliorate spinal scoliosis. This study investigated the effectiveness of intramuscular BoNT injection in vertebral curve correction and reviewed the possible influencing factors. PubMed, Medline, Cochrane Central Register of Controlled Trials, Web of Science, Airiti Library, and Index of the Taiwan Periodical Literature System databases were searched from inception until 7 September 2022 for eligible studies. The main outcome was the change in Cobb angle after BoNT application. Subgroup analysis was conducted according to differences in study designs, etiology of scoliosis, and methods used for target muscle selection. We enrolled three studies including 31 participants aged between 2 and 18 years. The meta-analysis revealed no significant reduction in the Cobb angle after BoNT injection (standardized mean difference, −0.783, 95% CI, −2.142 to 0.576). Study designs (<i>p</i> = 0.011) and methods used for target muscle selection (<i>p</i> = 0.017) but not etiology of scoliosis (<i>p</i> = 0.997) reached statistical significance between subgroups. In conclusion, the current meta-analysis does not support the application of BoNT in children and adolescents with scoliosis. However, a decisive conclusion could not be made due to high between-study heterogeneity and small sample size. More randomized controlled trials with appropriate target muscle selection and standard outcome measurement should be conducted to examine the efficacy of botulinum neurotoxin in treating scoliosis. INPLASY ID: INPLASY202290031.https://www.mdpi.com/2227-9067/9/10/1505botulinum neurotoxinsscoliosismeta-analysiscerebral palsy |
| spellingShingle | Yu-Chi Su Yu-Ching Lin Pei-Chun Hsieh Chung-Lun Liao Yao-Hong Guo Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis Children botulinum neurotoxins scoliosis meta-analysis cerebral palsy |
| title | Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis |
| title_full | Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis |
| title_fullStr | Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis |
| title_short | Effectiveness of Botulinum Neurotoxin in Treatment of Scoliosis among Children and Adolescents: A Systematic Review and Meta-Analysis |
| title_sort | effectiveness of botulinum neurotoxin in treatment of scoliosis among children and adolescents a systematic review and meta analysis |
| topic | botulinum neurotoxins scoliosis meta-analysis cerebral palsy |
| url | https://www.mdpi.com/2227-9067/9/10/1505 |
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