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PubMed1992

Brace treatment in idiopathic scoliosis.

A German multicenter study with consequent long-term follow-up of patients with idiopathic scoliosis after Milwaukee brace treatment in one out of seven Orthopaedic Clinics showed that brace weaning at the bone age of Risser 4 is followed by early loss of curve correction. According to Oberthaler et al. patients, who were furnished with a brace as outpatients, are inclined to practice a part-time wearing with different brace free intervals. In a longterm follow-up study of 328 patients with idiopathic scoliosis treated at the North German Scoliosis Center in Cuxhaven 123 compliant patients were examined 4 1/2 years after brace weaning. All were asked to wear their braces 23 hours a day and were weaned only at Risser 4-5 or Risser 5. The control rate was 93%. A gain of correction between 9 and 22% was the result. We analysed the composition of the group of 81 noncompliant patients. As far as we could find out the percentage of really non-compliant patients was only 19% compared with a total of 212 patients, who had finished their brace treatment at least 5 years ago. Eight patients (4%) with prebrace values of over 40 degrees Cobb had to be operated, though they were compliant. Based on these results, strict brace treatment in progressive idiopathic scoliosis is recommended, unless no more physiologic way of treatment is available.

Braces↗
PubMed2004

[The effect of anterior spinal release on severe adolescent idiopathic scoliosis].

OBJECTIVE: To explore the effect of anterior spinal release on severe scoliosis. METHODS: Twenty-six cases of severe scoliosis were retrospectively reviewed from January 1998 to December 2001. There were 7 males and 19 females with an average age of 15 years (ranging from 10 to 21 years). Twenty-four cases were classified according to King classification for adolescent idiopathic scoliosis, including King type I 4 cases, type II 9 cases, type III 5 cases, King IV 4 cases, King V 2 cases; another two cases were thoracolumbar curve. The major curves were averaged respectively 89.8 degrees, 66.5 degrees, 67.7 degrees, 61.2 degrees on standing, traction, bending and fulcrum film before operation. The distance of apex vertebrae deviated from sacral midline was 39.7 mm before operation. RESULTS: Six cases received anterior spinal release with posterior correction by one stage, 20 cases by two stages. The cases with two stage operation increased the spinal flexibility about 17.8 degrees after anterior release. The major curve was 52.6 degrees on average, and the distance of apex vertebrae deviated from sacral midline was 9.9 mm after operation. The major curve was 54.9 degrees on average, loss the correction 6.4% during follow-up. There was no complication related to the operation in this group. CONCLUSIONS: The anterior spinal release alone has little effect on severe scoliosis with flexibility less than 20% preoperation. The curve can be corrected to a great degree by anterior osteotomy for spine.

Adolescent↗
PubMed2002

Idiopathic scoliosis under 30 degrees in growing patients. A comparative study of the F.E.D. method and other conservative treatments.

PROBLEM ADDRESSED: Treatment of scoliosis under 30 degrees Cobb in growing patients remains controversial. Different orthopaedic devices have been developed and used with satisfactory results, alone or in combination with a variety of physiotherapy programs. The F.E.D. method is a dynamic three-dimensional therapy consisting in the application of derotational forces under spine stretching. This method offers some advantages over conventional conservative treatment for scoliosis: shorter treatment period, no use of plasters in many cases, better psychological tolerance, etc. PURPOSE OF THE WORK: In this work, the results of the F.E.D. method were compared to other conservative treatment techniques in scoliosis under 30 degrees Cobb angle and Risser 3 or less. RESEARCH METHOD: Both the F.E.D. group and the group of patients treated by traditional orthopaedic methods included 30 children. Patients were divided on the basis of the type of scoliotic deformity: thoracic, thoracolumbar or lumbar. SUMMARY OF RESULTS AND FINDINGS: The results obtained showed that patients treated with the F.E.D. method had a significantly better outcome than the other methods in terms of angle correction and shorter period of treatment necessary to reach correction. CONCLUSION: The F.E.D. method can be considered as the elective treatment in growing adolescents with scoliosis under 30 degrees.

Adolescent↗
PubMed2004

Anaesthesia for surgical correction of scoliosis with spinal cord monitoring--a case series.

OBJECTIVE: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test. METHODS: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series. RESULTS: We managed a series of sixteen cases of scoliosis in our hospital. Eleven patients were female and five were male with the age ranging from six to twenty two years. SSEPs were monitored throughout the procedure and wake up test was done intra-operatively after surgical manipulation of spinal cord. Intra-operative wake-up test was completed successfully in all the patients. None of the patients had any neurological damage and were also successfully extubated at the end of procedure. CONCLUSION: Intra-operative wake up test and SSEP monitoring are reliable methods for detection of intra-operative spinal cord ischemia during scoliosis surgery.

Adolescent↗
PubMed2004

[Thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis: a comparison of their clinical results].

OBJECTIVE: To compare the early clinical results of thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis. METHODS: Twenty-three cases with idiopathic right thoracic scoliosis were divided into 2 groups. Group A includes 8 females with average age of 14.8 years and average Cobb angle of 54 degrees . The Risser sign was +++ approximately ++++. These patients were operated on with thoracoscopic Eclipse instrumentation. Group B covers 2 males and 13 females with average age of 13.8 years and average Cobb angle of 57 degrees . The Risser sign was ++ approximately ++++. These patients were operated on with mini-open thoracotomic anterior instrumentation. The operative time, blood loss, postoperative drainage, instrumented levels, curve correction and early loss of correction of both groups were analyzed. RESULTS: The patients of group A had average operative time of (360 +/- 72) min, (629 +/- 145) ml of intra-operative blood loss, (7.4 +/- 1.1) of instrumented levels, (500 +/- 150) ml of post operative drainage, 74 +/- 14% of curve correction rate and (8.6 +/- 2.7)% of early loss of correction after 6 approximately 18 m follow-up. The patients of group B had average operative time of (246 +/- 64) min, (300 +/- 110) ml of intra-operative blood loss, (7.8 +/- 0.9) of instrumented levels, (210 +/- 90) ml of post operative drainage, (70 +/- 12)% of curve correction rate and (4.6 +/- 1.9)% of early loss of correction. The curve correction rates of thoracoscopic and mini-open thoracoscopic anterior correction were not significantly different (P >0.05). But the operative time, blood loss, postoperative drainage, and early loss of correction showed significant difference (P <0.05). CONCLUSIONS: Thoracoscopic and mini-open thoracotomic anterior correction for idiopathic thoracic scoliosis have their own indications. Both techniques are safe and effective to correct the idiopathic thoracic scoliosis with satisfied early results. But the early loss of correction of mini-open thoracotomic anterior correction is significantly less than that of thoracoscopic anterior correction.

Adolescent↗
PubMed2005

[The efficacy of third-generation instrumentation for the treatment of adult scoliosis].

OBJECTIVE: To evaluate the efficacy of third generation spinal instrumentation such as TSRH, CD and ISOLA for the treatment of adult scoliosis. METHODS: Thirty-five adult scoliosis patients including adult idiopathic and degenerative scoliosis were all surgically treated with third generation instrumentation such as TSRH, CD and ISOLA from July 1999 to January 2003. Preoperative mean cobb angles of major curves of the frontal plane was 58.1 degrees (42 degrees -95 degrees ). The patients received anterior combined with posterior correction or single posterior procedure. Mean follow-up was 20 months (10 - 48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and distance between C(7) and CVSL were measured. We assessed the subjective efficacy by questionnaire. RESULTS: Clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean lost of correction of the coronal plane in the last follow-up was 4.3 degrees , distance between the midline of C(7) and CVSL was corrected from 2.6 cm to 0.24 cm. Questionnaire in the follow-up showed that 89.3% patients were satisfied with operation results. Two cases occurred pneumatothorax and haematothorax. Three cases still complained about low back pain in 1 year after operation, among which 2 were adjacent degeneration and 1 was pseudarthrosis. CONCLUSION: Imageology assessment and patients self-evaluation shows that the third generation instrumentation could gain good correction and trunk balance in the treatment for adult scoliosis. And patients are more satisfied and have less complications.

Adult↗
PubMed2005

Prediction of curve progression in a goat scoliosis model.

OBJECTIVES: Currently, prediction of progression in scoliosis is accomplished by analysis of several factors, which provide only a broad percentage chance, rather than an accurate risk assessment, of deformity progression. A model for prediction of scoliosis progression was investigated using an experimental scoliosis: A goat model was used to predict curve progression based on the percentage of vertebral body wedging in the region of maximal deformity. METHODS: Structural, lordoscoliotic curves of significant magnitude (> or = 30 degrees) convex to the right in the thoracic spine were created in 15 immature goats using a rigid posterior asymmetric tether in combination with convex rib resection and concave rib tethering. At 12 weeks, all posterior tethers were removed, and the goats were observed for an additional 4-week period. Serial radiographs were used to document progression (defined as > or = 5 degrees) and vertebral body wedging within the maximal scoliotic deformity. RESULTS: During the additional 4-week observation period following removal of the tether, seven goats developed progressive curves (mean progression: +10.1 degrees, range: +6 degrees to +17 degrees) and eight goats developed nonprogressive curves (mean: -1.6 degrees, range: -8 degrees to +4 degrees). At the beginning of the observation period, the percentage of vertebral body wedging was 60.4% versus 50.2% in the progressive versus nonprogressive groups (P = 0.002). Thus, at 55.3% vertebral body wedging, prediction of curve progression was possible for 85% of progressors and 88% of nonprogressors. CONCLUSIONS: Prediction of curve progression is often difficult when based on skeletal maturity and curve magnitude alone. In an immature goat scoliosis model, however, in which these two factors are relatively well controlled, curve progression can be predicted based on the percentage of vertebral body wedging in the region of maximal deformity.

Animals↗
PubMed2005

[The operation treatment for severe and rigid idiopathic scoliosis].

OBJECTIVE: To discuss the operation treatment for the severe and rigid idiopathic scoliosis. METHODS: The clinical data of 24 patients with severe and rigid idiopathic scoliosis, 15 females and 9 males, with an average age of 17 (12 approximately 20) who had undergone operations from June 1999 to June 2003 were analyzed retrospectively. The patients were classified according to PUMC operative classification systerm, including 16 cases of type Ia, 2 cases of type Ib, 3 cases of type IIb2, and 1 case of types IIb1, IIc2, and IIc3 each. The average standing coronal Cobb angle was 98 degrees (80 degrees to 117 degrees ) and the average flexibility rate of the major curves was 20.8% (5% to 29.5%) before operation. Fifteen cases had sagittal deformities. Bone fusion was performed on all the cases according to the PUMC classification principles. 17 cases received anterior spinal release with posterior correction by two stages, and 2 cases by one stage. 5 cases received one-stage posterior correction. All the patients were followed up for 12 approximately 30 months (18 months on average). RESULTS: The mean standing coronal Cobb angle of the major curves was reduced to 58 degrees (32 degrees to 100 degrees ) after operation with a correction rate of 41.0% (10.9% to 61.0%). The results of sagittal plane correction were satisfying. The mean Cobb angle of the major curves at the final follow up was 63 degrees (31 degrees to 104 degrees ), and the mean lost was 5 degrees (0 degrees to 10 degrees ). One case had to undergo revision surgery because of hook displacement. One case had steel wire broken but without neurological symptoms and only needed observation. No pseudoarthrosis and decompensation occurred. CONCLUSION: Compared with vertebral osteotomy for the correction of scoliosis, the anterior spinal release combined with posterior correction and simple posterior correction have the advantages of low risk, less blood loss, and low infection rate. They can be used effectively and safely for the correction of idiopathic severe and rigid idiopathic scoliosis. The key points for the surgical procedures are appropriate correction and recovery of the balances of the coronal and sagittal planes.

Adolescent↗
PubMed2005

Recalcitrant scoliosis in Proteus syndrome.

Proteus syndrome is a rare congenital condition with various clinical features such as hemihypertrophy, macrodactyly, subcutaneous masses, brain-like hyperplasia of the soles and/or palms, epidermal naevi and scoliosis with other mesodermal malformations. Multifocal overgrowth can affect various tissues causing severe functional and cosmetic disability, but intellectual and language development are mostly normal. Orthopaedic problems include macrodactyly, hindfoot deformity, limb length inequality, genu valgum and scoliosis. Usually, scoliosis does not respond to bracing, and surgical intervention may be required. Despite surgical correction, instrumentation and fusion, progression of deformity can occur. The authors describe a case with a Th7-L2 scoliosis, which completely relapsed, 20 months after posterior instrumented fusion. Surgery should not be undertaken lightly, given the abnormal growth potency typical for Proteus syndrome.

Child↗
PubMed2005

[Evaluation and treatment of congenital scoliosis with split cord malformation].

OBJECTIVE: To discuss the diagnosis and surgical treatment of congenital scoliosis (CS) with split cord malformation (SCM). METHODS: From May 1999 to June 2004, 353 cases of CS were admitted, and 58 cases were diagnosed CS combined with SCM via myelography and (or) CTM. According to Pang's classification for SCM, patients were divided into type I SCM and type II SCM. Two cases gave up operation, and surgeries were performed in 56 patients. Except that one case with arachnoid cyst underwent intraspinal exploration, all other 55 cases underwent spinal correction without dealing with the intraspinal abnormalities. Clinical manifestation, radiological findings, operative methods and results were retrospectively analyzed in this paper. RESULTS: There were 11 patients (19%) with type I SCM and 47 patients (81%) with type II SCM. In the 56 cases who had surgical treatment, the Cobb angle in the patients with type I SCM (11 cases) was (60 +/- 25) degrees, and in type II SCM (45 cases) was (67 +/- 21) degrees pre-operation. The Cobb angle in type I SCM was (29 +/- 13) degrees and in type II SCM was (39 +/- 19) degrees post-operation, with the correction rate (51 +/- 17)% and (41 +/- 24)% respectively. No statistic differences were found between both types. And there were no new neurological deficits in both groups after the spinal correction operation. After average 17.3 months (4-59 months) follow-up, the correction loss was (6 +/- 10) degrees, (5 +/- 8) degrees in 7 patients with type I SCM and (6 +/- 10) degrees in 19 patients with type II SCM. There was no statistic difference in correction loss between both types. In the follow-up, the neurological symptoms and signs of the patients were stable. CONCLUSION: Considering the incidence of intraspinal anomalies in patients with congenital scoliosis, intraspinal examination via myelography, CTM or MRI should be performed prior to spinal correction surgery. For congenital scoliosis with type I SCM, the bone spur need not be excised before spinal correction if there is no signs of spinal cord tethered and the bone spur locate in the middle of the split cord where there are much space to accommodate it. For congenital scoliosis with type II SCM, if there are no progressive neurological manifestations, the split cord in the single tubular can tolerate the manipulation of spinal correction as the normal spinal cord.

Adolescent↗
PubMed2005

[Qualitative and quantitative aspects of risk-factors of dentofacial system anomalies in children with postural disorders and scoliosis].

The purpose of the study was to investigate qualitative and quantitative aspects of risk-factors of dentofacial system anomalies in children with postural disorders and scoliosis. We have examined 600 children at the age of 6-15 with postural disorders and scoliosis (study group), also 100 children without postural disorders and scoliosis (control group) and 100 practically healthy children (children without postural disorders, scoliosis and dentofacial anomalies). The spread of dentofacial anomalies in children of the study group was 70.2%, in the control group -- 41.0%. For the estimation of the degree of association between the disease frequency and certain risk-factors, chi(2) indicator has been calculated. In the examined population simultaneous existence of several factors prevailed. High frequency of the combination of risk factors (simultaneous existence of 5-7 factors in average) was found, which was much more frequent (p<0.001) in the contingent of the study and the control groups (3-4 times) than in the group of practically healthy children.

Adolescent↗
PubMed2006

Corrective surgery of congenital scoliosis with type II split spinal cord malformation.

OBJECTIVE: To investigate the corrective results of congenital scoliosis with type II split spinal cord malformation. METHODS: By reviewing the medical records and roentgenograms of congenital scoliosis patients with type II split spinal cord malformation that underwent corrective surgery, septum location and length, curve type, coronal and sagittal Cobb's angles, apical vertebral rotation and translation, and trunk shift were measured and analyzed. RESULTS: A total of 23 congenital scoliosis patients with type II split spinal cord malformation were studied, 6 cases were due to failure of segmentation, 8 cases due to failure of formation, and the remaining 9 cases due to mixed defects. The fibrous septums were located in the thoracic spine in 8 patients, lumbar spine in 4 patients, thoracic and lumbar spine in 10 patients, and from cervical to lumbar spine in 1 patient The septum extended an average of 4.9 segments. Corrective surgeries included anterior correction with instrumentation in 2 patients, posterior correction with instrumentation in 11 patients, anterior release and posterior correction with instrumentation in 6 patients, anterior and posterior resection of the hemivertebra and posterior correction with instrumentation in 4 patients. The pre- and postoperative coronal Cobb's angles, apical vertebral translations, apical vertebral rotations, trunk shifts were 61.9 degrees and 32.5 degrees (P < 0.001), 48.9 mm and 31.5 mm (P < 0.001), 1.2 and 1.1, 12.7 mm and 8.2 mm, respectively. The average correction rate of coronal Cobb's angle was 47.5%. The sagittal balance was also well improved. The fibrous septums were all left in situ. There was no neurological complication. CONCLUSION: For congenital scoliosis with type II split spinal cord malformation, positive correction results with no neurological complication may be obtained without resection of the fibrous septum.

Adolescent↗
PubMed2006

Anterior instrumentation for correction of adolescent thoracic idiopathic scoliosis: historic prospective study.

AIM: To compare the results of anterior instrumentation and standard posterior procedure for correction of adolescent thoracic idiopathic scoliosis. METHODS: The study included 50 patients with adolescent thoracic idiopathic scoliosis who underwent corrective spinal surgery. Anterior spinal fusion by use of modified Zielke ventral derotation system (anterior approach to spine through thorax) was performed in 25 patients, whereas posterior approach was used in 25 patients. The average preoperative thoracic curve in coronal plane was 66.7 +/- 9.9 degrees and 65.0 +/- 11.7 degrees in the anterior and posterior correction groups, respectively. The median age of patients before surgery was 14 years (range, 12-18) in the anterior and 16 years (range, 13-18) in the posterior correction group. Women-to-men ratio was 22 to 3 in each group. Coronal and sagittal correction, apical vertebral body rotation, rib hump, and rib depression correction were measured before surgery and at the first (30 days after surgery) and at the second follow-up visit (at least 2 years after surgery). Posteroanterior and laterolateral radiographs of the erect spine were used (according to the method of Cobb and Nash-Moe) to assess coronal, sagittal, and horizontal plane corrections. Rib hump and rib depression were measured with Thulbourne-Gillespie measuring device. The differences in scoliosis correction parameters in the two groups were tested with Student two-tailed t test. RESULTS: In the coronal plane, the thoracic curve of 66.7 +/- 9.9 degrees before surgery in the anterior correction group was reduced to 14.8 +/- 8.7 degrees after surgery (78.1 +/- 12.4% relative correction), and the curve of 65.0 +/- 11.7 degrees in the posterior correction group was corrected to 29.2 +/- 7.8 degrees after surgery (55.1 +/- 8.6% relative correction) (P<0.001). Apical vertebral body rotation correction according to the Nash-Moe classification from 2.0 +/- 0.4 degrees to 0.8 +/- 0.6 degrees was achieved in the anterior correction group (62.0 +/- 26.6% relative correction) and from 1.7 +/- 0.5 degrees to 1.4 +/- 0.5 degrees in the posterior correction group (12.0 +/- 21.8% relative correction) (P<0.001). Rib hump correction from 22.4 +/- 15.5 mm to 5.4 +/- 5.2 mm was found in the anterior correction group (70.9 +/- 26.0% relative correction) and from 25.3 +/- 7.0 mm to 13.6 +/- 6.8 mm (48.4 +/- 16.5% relative correction) in the posterior correction group (P = 0.084). CONCLUSION: Compared with the standard posterior approach, the anterior approach resulted in better three-dimensional correction of idiopathic thoracic scoliosis.

Adolescent↗
PubMed2006

Detection of adolescent idiopathic scoliosis.

The aim of our study was to evaluate the current methods of detection of adolescent idiopathic scoliosis. Data were collected from 100 consecutive patients with adolescent idiopathic scoliosis referred to the Scoliosis clinic in 2000. The age of the patient, the Cobb angle at presentation and the person who first noticed the deformity were recorded. Sixty three percent of the cases were detected by family or friends. The number of cases being detected at school had dropped considerably to 8%. Fifty six percent of all cases presented with a Cobb angle of more than 40 degrees. Our study shows that the most common method of detection was by family and friends. Seventy percent of these cases were detected when the deformity was advanced with Cobb angles of more than 40 degrees. There was a drop in the number of cases detected at school when most of the curves are at an earlier stage. We believe that greater awareness is needed in the community, for earlier recognition of idiopathic scoliosis.

Adolescent↗
PubMed2006

Efficacy of the symmetric, patient-oriented, rigid, three-dimensional, active (SPoRT) concept of bracing for scoliosis: a prospective study of the Sforzesco versus Lyon brace.

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 prospective, 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 clinically 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) abandoned.

Adolescent↗
PubMed2006

"Syndrome of contractures" (according to Mau) with the abduction contracture of the right hip as causative factor for development of the so-called idiopathic scoliosis.

The article provides basic explanation of "syndrome of contractures" (Mau) at newborns and babies and it's conjunction with biomechanical etiology of the so-called idiopathic scoliosis (Karski 1995-2006). The authors analyzed children with "syndrome of contractures" and noted its relevance to some clinical symptoms at children with scoliosis. Newborns and babies with clinical signs of "syndrome of contractures" require further spine examination already at age of 3-4 in order to detect "danger of oncoming scoliosis" and to introduce neo-prophylaxis. The research based on "syndrome of contractures" can explain predominance of female gender of patients with scoliosis, sides of curves, side of rib hump, progression and sensibility to new rehabilitation exercises.

Child↗
PubMed2006

Sagittal configuration of the spine in girls with idiopathic scoliosis: progressing rather than initiating factor.

Thoracic hypokyphosis with increasing axial rotational instability is claimed to be a primary factor for the initiation of Idiopathic Scoliosis (IS) according to some authors. The objective of this study was to compare the sagittal configuration of the spine in two groups of girls with and without scoliosis in order to determine whether thoracic hypokyphosis and/or lumbar hypolordosis are initiating factors for AIS or not. A group of 207 consecutive non-treated girls diagnosed with IS (12.7 y +/- 1.8) measured with the Formetric system were compared to a control group of 45 non-scoliotic girls of the same age (12.4 y +/- 2). The Cobb angle for the whole scoliosis sample was 26 degrees +/- 13.6 and the angle of axial rotation 12.4 degrees +/- 7.7 (Perdriolle). The patient group was divided into subgroups by their Cobb angle ie G1 (5 degrees -19 degrees, n=79), G2 (20 degrees -34 degrees, n=81), G3 (<or=35 degrees, n=47). The values of the kyphotic angle and lordotic angle were compared. The kyphotic angle was not significantly different in the patients group (48.7 degrees +/- 9.4) compared to the control group (51.5 degrees +/- 10) while the lordotic angle was slightly but significantly lower in the patient group (39.3 degrees +/- 9.4) than in control (42.3 degrees +/- 8.8); however, the lordotic angle in G1 (40.5 degrees +/- 8.3) was not lower than that of the controls. Non-scoliotic girls and those with a mild scoliotic curve had the same angle of thoracic kyphosis and lumbar lordosis. Both angles tended to decrease in progressive curves. Neither thoracic hypokyphosis or lumbar hypolordosis are considered to be initiating factors for scoliosis but are factors in its progression.

Adolescent↗
PubMed2006

A controlled prospective study on the efficacy of SEAS.02 exercises in preventing progression and bracing in mild idiopathic scoliosis.

UNLABELLED: There is low evidence on the possible efficacy of exercises to treat idiopathic scoliosis, graded as C by the existing Italian Guidelines. Our aim was to verify if exercises quality has an effect on results. DESIGN: Prospective controlled study on idiopathic scoliosis patients that performed only exercises to avoid progression. TREATMENT: SEAS Group make exercises according to the protocol SEAS.02 (Scientific Exercises Approach to Scoliosis, version 2002). The CONT Group performed exercises at a local structure according to different protocols preferred by the treating therapists. Population. SEAS: 48 patients (37 females), 12.5+/-2.2 years, 15.1 degrees +/-5.7 degrees Cobb (degrees C), 9.0 degrees +/-3.3 degrees Bunnell (degrees B). The difference in the number of braced patients within the first year has been almost statistically significant (P=0.07): 1 in SEAS vs. 5 in CONT. Cobb degrees improved with treatment (P<0.05) only in the SEAS group. Clinical results (variation of at least 5 degrees C or 2 degrees B) were better in SEAS than CONT. Not all exercises for scoliosis have the same efficacy: this study proves the short term efficacy of SEAS.02 when compared to usual care.

Adolescent↗