A systematic literature review was undertaken to determine the evidence for conservative care in adult deformity. Common treatment recommendations, including physical therapy, chiropractic care, bracing, and injections, were examined. There is a lack of consensus on conservative options in adult scoliosis but agreement that nonsurgical options be tried before surgery. After a careful systematic review and grading of the literature on the subject, there is Level III/IV evidence allowing only a Level 2C very weak treatment recommendation for any particular conservative care treatment as an option in adult deformity. Additional clinical research is needed to clarify the appropriate options.
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